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COVID-19 Impact – Healthcare Billing Organizations

By: exdionrcm

Impact of COVID-19 On Healthcare Billing Organizations And How They are Dealing With It

The world is staying in but the healthcare providers and medical practitioners are now more active than ever. Their battle on the frontlines against the deadly coronavirus has not just put their lives in jeopardy but has also complicated the revenue cycle, impacting healthcare billing organizations.  .

The challenges in the Revenue Cycle can be primarily attributed to the monumental rise in patients visiting healthcare organizations seeking treatment. This unprecedented situation can easily lead to chaos with its impact trickling down to the billing offices. These offices need to keep themselves afloat but for small organizations with limited resources and plummeting cash in hand, the outlook might be leaner than expected.

According to reports, the American Medical Association (AMA) has announced that it is fast-tracking the development of a unique Current Procedural Terminology (CPT) code for reporting novel coronavirus testing. CMS has also recently published guidance on billing and reimbursement for treating COVID-19. The authorities are at the forefront of the battlefield, easing operations for healthcare billing organizations. Let us discuss some unique scenarios that COVID-19 has brought forth and how the billing organizations are dealing with the crisis

In this article, let us talk about the Key Drivers for Revenue Cycle Management (RCM) in 2020 and how the healthcare industry can identify opportunities for improvement in their revenue cycle.

Remote Work Is Now a Necessity

The impact of the deadly coronavirus is its high infection rate which has given birth to the need for social distancing and hence, remote work. Healthcare billing organizations have to function with key staff working from home, diminishing productivity and challenging collaboration issues that make processes more time-consuming.

Cancellation/Deferment of Elective Surgeries

Healthcare resource management is another hurdle in front of medical personnel and the authorities. The allocation of resources needs rethinking in the time when the coronavirus pandemic has overburdened healthcare institutions. This is brand-new territory.

  • CMS has issued guidelines asking people to not burden hospital staff with non-essential procedures and elective surgeries so as to empower such organizations with the capability to deliver their 100 percent to covid-19 victims.
  • Revenue cycle professionals have also been urging patients who cannot afford to spend from their own pockets to postpone any such elective procedures at least until they have a payment plan.
  • Additionally, the coronavirus infection is also making patients revisit their decision of going under the knife for elective surgeries that can be performed after the crisis has faded.

In fact, according to a small study by Jefferies, as the number of U.S. coronavirus cases rise, 55% of healthcare respondents said they expect deferrals and cancellations to increase. 29% of interventional cardiologists in the first week of March were already reporting cancellations or postponements.


It should be noted that the cancellations and postponements are likely to cause a major financial blow on healthcare organizations, disrupting their Revenue Cycle. Conversely, it has the potential to act as a blessing in disguise for the insurers, who would otherwise have to pay for the expensive orthopedic and cardiac procedures.

Significant Rise in Pathology and Laboratory Tests

In a general setting, 75% of all healthcare interventions require laboratory test results for diagnosis and treatment plans. With the coronavirus pandemic taking over cities, more and more tests are being conducted at laboratories to test for the presence of the virus in suspected individuals.

The focus should be shifted towards correctly directing resource allocation so as to give a boost to the Revenue Cycle by reducing wasteful spending. This can be done by recognizing techniques that promote the effective utilization of laboratory testing resources and reducing unnecessary tests. As pathology centers increase their capacity to deliver their services, healthcare billing organizations need to be prepared to support the surge.

Smart Revenue Cycle Management: How Automation Can Help

As discussed above, the coronavirus pandemic brings with it challenges that the modern healthcare system has not dealt with before. Hence, to speed up operations to deal with the surge, effectively manage remote work and divert key staff towards core functions, automation is the answer.

A vital offering of automation is its ability to disconnect repetitive, predictable processes from human interventions. With zero people dependency, billing organizations can maintain the accuracy of work, faster turnaround time and maximum productivity. AI automation can take care of manual workflows, assure compliance and offer billing organizations with insights into KPIs, helping them keep their business running smoothly in these trying times.

Ending Notes

The coronavirus pandemic is pushing innovation, making healthcare billing organizations look for easier, quicker and more efficient ways to deal with the unexpected impact on their business. Savvy, technology-driven organizations can stay one step ahead by embracing automation as a part of their RCM strategy

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