The world last faced a major pandemic of Spanish Flu in 1918 to 1920, which was nearly a century ago. The world has since moved forward, and economies have flourished, and technology advancements have influenced progress in nearly every country.
However, since last year the Covid-19 outbreak has disturbed the daily routine of millions across the globe. The Coronavirus was declared a global pandemic by the World Health Organization (WHO) on March 11, 2020. The massive spread of the virus disrupted normal routine from all walks of life, and everything was closed from businesses, schools, airports, restaurants, and cinemas.
Apart from different sectors, the novel Coronavirus pandemic significantly impacted the healthcare system and the country is not only facing an economic crisis but a healthcare crisis as well. People have been asked to practice social distancing and perform work or provide services remotely.
The Impact of Covid-19 on Healthcare System
There have been few economic recessions in the past, but the healthcare system has relatively been immune as people get ill in both good and bad times and the demand for healthcare services has been constant over the years. But since Covid-19 outbreak, the number of patients registering for treatment of acute or chronic disease or coming in for emergency care declined throughout the country.
The admission in hospitals and different healthcare centers has fallen considerably in the last 10 months, making it difficult to collect payments, maintain a revenue cycle, and sustain in the long run amid the growing number of challenges such as
- The widespread uncertainty surrounding the pandemic
- Growing number of positive cases
- Stay at home restrictions and social distancing
- No possible solution or vaccine for the Coronavirus that has stopped people from getting treatment from a hospital even for an acute illness.
Many patients may have consulted with their physicians and made informed decisions to avoid hospitalization in order to prevent the virus spread. The sudden surge in unemployment has also led many people to lose their employer-based insurance, and on the other hand, insurance providers have introduced stringent guidelines and policies for those who want to get privately insured.
The constant decline in routine medical services has led many medical practices to face tremendous financial crisis, especially those that were financially vulnerable before the Covid-19 pandemic.
The Numerous Healthcare Problems due to the Coronavirus Pandemic
Healthcare providers, practitioners, and workers are on the front lines in countering the Coronavirus disease and not only have to treat the patients but also avoid contracting the disease. With the number of positive Covid-19 patients rising, medical practices have to face a shortage of Personal Protective Equipment (PPE), medical supplies, ventilators, and medical staff.
As most of the population has some kind of medical insurance, the medical practices submit a medical bill or claim to the insurance companies to reimburse the healthcare services rendered to the patients. People not having any medical coverage are asked to pay from their own pockets.
With the number or unemployment rising, many people with no insurance plan are not going to hospitals for treatment fearing payment of high medical bills. Insurance companies also are making strict evaluations and denying payments to medical practices due to incorrect medical billing and coding.
The decrease in hospital admissions, postponement of scheduled appointments and screenings, cancellation of planned treatment, and increase in denied or rejected medical claims has considerably impacted the revenue generation cycle and led medical practices to look for numerous ways to cope and sustain during and after the pandemic.
When should a patient be tested for Covid 19 with Viral test ( nucleoid acid or antigen test)
The CDC is regularly updating guidance on who physicians should test for COVID-19.
Currently, there are five considerations for when viral tests, which are used to diagnose acute infection, are appropriate, though final decisions about testing are made by state and local health departments or health care providers based on local situations. These considerations include:
- When individuals present signs or symptoms consistent with COVID-19
- To control transmission when an asymptomatic individual is suspected to have been exposed to SARS-CoV-2
- For early identification of asymptomatic individuals without known or suspected exposure in special settings
- To determine the resolution of an infection
- In public health surveillance efforts for SARS-CoV-2
Clinicians should consult with their local or state health department or the labs that perform their diagnostic services.
The way Covid-19 pandemic has unfolded shows that many reforms are needed in the healthcare sector both in the public and private level. Policies have to be made to not only provide quality healthcare services but also reduce the cost of medical bills.
There are many aspects that medical practices have to consider to not only cope with ongoing Covid-19 such as extending testing capacity, availability of PPEs, separate entrance and accommodation of patients with the virus, and also improving the financial health by using accurate medical coding and billing processes.
How Medical Practices Need to Cope and Manage Effectively
We still are a long way from determining the full scale of impact from the Coronavirus pandemic, but medical practices can make better plans to cope and manage healthcare services delivery to the patients. Some of the things that medical practice needs to implement are
- Forming a dedicated pandemic task force that includes healthcare workers and administrative support staff
- The entire medical staff must be given training on applying the best safety measures and wearing PPE to prevent contraction of the virus
- Keeping a full inventory on necessary medical equipment and supplies from surgical masks, N-95 respirators, gloves, disinfectants, gowns, and medicines
- Screening the healthcare workers and staff for symptoms of the virus and asking them to quarantine on detection of the virus
- Establishing guidelines and systems that can help employees work remotely. The doctors, physicians, and nurses may not work remotely, but the medical coders, billers, and transcriptionist can and help streamline the revenue cycle.
- Incorporating modern digital tools and solutions such as medical coding and billing software, Telemedicine, and Artificial Intelligence (AI) systems.
- Collaborating with revenue cycle management specialists to optimize the revenue collections, reduce the denied medical claims, and ensure the medical coding and billing is done in compliance with changing healthcare policies.
The integration of digital solutions is the need of the hour and can help medical practices efficiently address the challenges, automate key processes, streamline work under given crisis and limitations, and improve productivity.
The financial stability and sustainability that a medical practice looks for lies squarely on the revenue collection process that depends on the effectiveness of the medical coding and billing process.
Today, the revenue cycle may seem easy, but medical billing process is complicated from patient appointment scheduling, the input of correct medical codes, compliance with health regulations, integration of Electronic Health Records (EHR), submission of medical claims to track denials and unpaid bills, and correction of error and resubmission of medical claims to ensure full payments.
Medical practice needs to partner with consultancy firms that design and develop custom billing software according to specific needs that are cost-effective and can boost productivity.