When the Covid-19 pandemic broke out in the US and other parts of the world, no one had any idea about the kind of impact it was going to make globally. The healthcare industry reports a total loss of about $202.6 billion due to Covid 19. Medical billing and coding companies are handling their own shares of lost businesses, drastic process changes and monetary mislays because of the pandemic.
A lot of RCM (Revenue Cycle Management) providers are rethinking their strategies and current workflows.
How exactly has Covid 19 changed the RCM processes? What does the future hold for the industry? Keep reading to know more.
Loss of revenue
One of the significant challenges that Medical Billing and Coding service providers have had to handle thanks to the pandemic, was a plummeting drop in revenue. Compared to 2019, 2020 saw a 40% drop in non-Covid-19 patient billing, which meant medical billing companies had a lot less work and made lesser money.
Increased claim rejections
Millions of people lost their jobs or had to take a pay cut because of Covid-19. When people lost jobs, they also lost access to employer-sponsored health insurance. When they had a pay cut, they could not pay for additional health costs from their pockets. These problems had increased claim rejections and led to delayed billing. As a result, unproductive touches had risen in the last 20+ months.
Reduction in billing volumes
When the number of Covid-19 cases shot through the roof, many providers took a break from patient collections, to ease the stress on patients. Most of the states in the United States also banned surprise billing when it came to Covid-19-related testing and treatment.
As a result, the patient billing reduced by about 47% in just three months. Now, this directly affected the RCM cycle.
Months of complete lockdown pushed Medical Billing and Coding companies to adapt to telecommuting. As a result, the staff suddenly had to handle random work volumes from home, without access to the technology and tools they had in their workplace.
As the number of Covid-19 cases increased exponentially, the pressure on RCM service providers also escalated. New procedures were added in hospitals and claims were rejected left and right. This led to a sudden increase in the number of appeals and resubmissions.
Government policies changed by the day and as a result, learning and unlearning became everyday activities.
All this had to be done while maintaining the same Service Level Agreements (SLAs), which was the biggest challenge!
Assess your current process
If you are a Medical Billing and Coding company or any RCM service provider, start analyzing your current RCM processes. Compare the process during the pre and post-Covid periods and identify gaps. Note down the challenges you faced in the last two years and sit together as a team to determine what you should be doing to handle such a situation again.
Investing in training and documentation
One of the biggest challenges RCM providers have had to face with a remote work setting was training existing and new employees. Working with a group of employees who are not up to date with process requirements will affect productivity. Start investing in training and documentation to get an order of things and streamline learning processes.
Telecommuting will become a common practice across industries, and training and documentation will help smooth functioning. Be it Medical Billing and Coding, quality management, network support, operations, or sales and marketing – the time and effort you spend in documenting processes will pay.
With the proper documentation in place, your employees will function at total capacity, despite their location.
Invest in technology
Technology will help RCM business providers bounce back to their old selves and balance out the losses and inefficiencies of the last few years. Digital RCM is something you should be keenly focusing on in the next couple of years. Intelligent technologies like AI, Machine Learning, and innovative AR tools will make processes automated, compelling and more productive.
Quintessence’s Codessence tool has been our biggest strength during the pandemic. This Machine Learning coding tool has helped our clients easily handle large coding operations and bill volumes and improve accuracy and speed.
Another intuitive tool from us is Reimburssence. This tool uses a combination of algorithms and past learning to make decisions on claims quickly. As a result, your bad touches reduce and you can invest your time and efforts only on claims that will undoubtedly lead to closure or payments.
It takes time to build and use such tools. However, they are going to be the difference between struggling and successful RCM service providers in the future.
While the Covid-19 pandemic has definitely caused disorientations in the Revenue Cycle Management processes, experts agree that many of these problems had already existed in the past, thanks to outdated techniques and mundane tools. The pandemic has just exacerbated the issues and bought them to light.
Medical billing and Coding is an industry that is here to stay. Invest in documenting your process flow and training your staff. Spend money getting the best-in-class tools and technology to support your workflow. Be in constant touch with the updates in the healthcare industry, and more importantly, keep yourself prepared to handle unforeseen situations that may catch you unawares.
All these are foundations on which your brand can confidently stand and grow for years to come.
Get in touch with us if you want to know more about Quintessence’s RCM processes and technology.
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