COVID-19 Is Impacting the Healthcare Revenue Cycle

March 10, 2020 - As entire nations are urging their citizens to remain indoors to prevent COVID-19, healthcare professionals are more involved than ever in response to the latest coronavirus outbreak. This operation has a huge effect on the health care revenue cycle and the finances of the providers.

There are more than 109,500 confirmed cases of COVID-19 across the globe, including 3,993 new cases in the last 24 hours. Of those cases, 423 are in the US where, since January 21, 2020, 19 people have died from the novel strain of coronavirus, reports the CDC.

The epidemic has been a significant concern for health care workers on the frontline of monitoring and treating contaminated people. Among their concerns is the effect COVID-19 would have on the revenue cycle for healthcare and financial operations.

As reported by the Wall Street Journal, stocks collapsed as a result of the global COVID-19 outbreak, and the phenomenon was not immune to health care providers. On March 10, 2020, stock prices for large for-profit healthcare systems including Tenet Healthcare Corporation and Community Health Systems declined sharply, with many remaining in the red. However, non-profit health systems, university medical centers and physicians ' practices also face financial difficulties arising from COVID-19.

Recently, a major study confirmed wuhan findings, showing a case-fatality rate of 2.3%. Among seriously ill people the death rate was substantially higher. The intensive services needed to treat COVID-19 patients placed strain on resources which are already restricted.

Experts from the state of Johns Hopkins Bloomberg School of Public Health said as a contrast, in the United States there are about 46,500 medical ICU beds and maybe an equivalent number of other ICU beds that could be used in a crisis. The gap between demand and resources is obvious, although spread over several months.

In addition, many hospitals already run low on vital medical supplies such as masks and ventilators, and many more are bracing for personal protective equipment shortages due to the coronavirus. Healthcare providers are increasingly developing emergency preparedness measures, searching for places for patients to overflow, conducting medical services, recognizing and protecting personnel, and more. To help organizations overcome the current obstacles, the government and payers are working to reduce the sales cycle barriers that COVID-19 poses.

BILLING AND CODING FOR COVID-19

Keeping the billing office working through an epidemic is vital to keeping hospitals and clinics open to patients who are infected who need treatment. But this can be a challenge, especially for smaller organizations with limited cash on hand to meet COVID-19 requirements.

CMS has been at the forefront of helping clinicians deal with the coding and medical billing element of COVID-10 testing and treatment. The agency recently published two versions of the Healthcare Standard Procedure Coding System (HCPCS), which laboratories will use to charge for some COVID-19 diagnostic tests, including those produced in-house according to new FDA guidelines.

On 10th March 2020, The American Medical Association (AMA) announced that it is fast-tracking the development of a unique Current Procedural Terminology (CPT) code for reporting novel coronavirus testing. CMS also recently released guidance on billing and reimbursement for treating COVID-19. The agency reminded providers that Medicare will pay for evaluation and management (E/M) and other services furnished in a beneficiary’s home by a physician or non-physician practitioner. Medicare will also reimburse providers for many non-face-to-face services used to assess and manage a beneficiary’s condition, the agency stressed.

The COVID-19 outbreak is already highlighting issues surrounding patient financial responsibility. Several reports have surfaced of patients being left with thousands of dollars in medical bills after seeking care for potential coronavirus symptoms.

In the age of highly deductible insurance plans and other cost-sharing agreements, healthcare providers are still struggling to establish collection strategies. Therefore, being able to bring these new techniques into action during an emergency can be almost difficult. Last week, America's Health Insurance Plans (AHIP) confirmed it is introducing strategies to reduce the out - of-pocket costs for those seeking COVID-19 testing and treatment. Each of these solutions includes medical tests when requested by a doctor.

COVID-19 puts tremendous pressure on an overburdened healthcare system, exceeding the resources of hospitals, emergency departments and outpatient centers. This leads to vital personnel, space and equipment shortages, which can have a detrimental effect on patient care, the National Academy of Medicine (NAM).