Emergency departments (ED) are an integral part of hospitals and medical practices and provide the best medical or surgical care to patients arriving in need of immediate care.
EDs are the most active and critical department of a hospital with a constant flow of incoming patients suffering from either acute illness or injury. A typical ED consists of nurses, doctors, and physicians who address a wide range of medical issues such as cardiac arrests, strokes, fatal injuries, pregnancy complications, asthma and systems associated with the coronavirus.
EDs serve as the first point of contact, and people of nearly every age are given particular medical care based on their injury or illness.
ED is the most crucial and intensive department within a hospital as many times, the question of life and death hangs on a thin line. Emergency departments are supposed to be equipped with all the modern and essential equipment and accessories to render timely acute, emergency, trauma care services.
How Covid-19 has impacted the Healthcare System
According to the Centers for Disease Control and Prevention, the ED visits have declined a staggering 42% as patients even suffering from acute or chronic ailments prefer to avoid hospital visits to prevent getting contracted and also prevent the transmission of the novel Coronavirus.
There was a general belief that the emergency department would have seen an increased number of patients amid the growing pandemic. On average, if a medical practice sees 100 patients wanting admission and 200 to 300 patients getting evaluated for common symptoms.
The number of total patients would have increased if patients coming in to check Covid-19 symptoms had been added. But on the contrary, there has been a significant decline, and the major reason is people avoiding or delaying care even for serious acute or chronic ailments due to fear of getting Coronavirus.
The regular delivery of medical services and payments was halted, along with the postponement of scheduled treatment and surgeries. The challenges that make it difficult for healthcare providers to manage and sustain the medical operations are
- The growing number of Covid-19 positive cases
- The uncertainty of proper vaccination or cure for the virus
- Loss of revenue due to claim denials
- Lack of integration of modern technology
- Low admission of patients in the emergency department
The testing times call for a balanced combination of strategy, technology, resources, and processes to improve healthcare services, streamline the clinical and administrative tasks, increase patient satisfaction, and ensure a better chance of profitability and sustainability.
How Emergency Department needs to Manage Key Tasks
For every new patient in the ED, the nursing staff and physicians must select the primary reason for the admission to the ER and draw up the ICD-10 (International Classification of Diseases) emergency diagnosis codes list. The selection of code depends on the type of illness or injury and can be anything from chest pain to dislocated bone or pneumonia.
The patient data at the time of admission is extremely important as it eventually becomes part of the medical bill or claim and results in reimbursement for the medical services given to the patients.
With growing challenges, the limited in-house staff, no matter how capable, may find difficulty in managing the scheduling of appointments, selecting appropriate codes, submitting medical bills, tracking payment, and following up denials and accounts receivables.
As most patients have insurance coverage, medical practices need to carefully analyze and draw contracts with insurance companies that result in fair reimbursement for the healthcare providers and faster turnaround times.
Medical providers not only have to manage the low ED volume of patients but take proper steps amid the pandemic, which includes
- Provision of PPE (Personal Protective Equipment) for staff and physicians
- Availability of ventilators and other medical equipment and medications
- Devising new visitation policies
- Making a mask mandatory at all times and regular hand sanitation
- Screening and testing for Coronavirus; and
- Social distancing
The evolution of HIPAA (Health Insurance Portability and Accountability Act) and ACA (Affordable Care Act), along with regular changes in medical codes, has left the ED of medical practices not only improving medical facilities but making changes in its claim submission, collections, coding, and billing processes.
Emergency departments have developed strategies to handle coronavirus patient surges such as addressing limited space in their facilities.