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Covid-19 is creating unique healthcare revenue cycle challenges around billing and coding

Covid-19 is creating unique healthcare revenue cycle challenges around billing and coding

As we know the world is going through the crisis of COVID-19 and the government of every country is urging people to stay at home. On the other hand, healthcare providers are battling on fields to mitigate the intensity of novel coronavirus. According to the latest data by world health organization (WHO), globally there are about 4,347,935 confirmed cases of novel coronavirus including 297,241 deaths as of 15th May 2020. All sectors have been impacted by COVID-19 with different proportions. As far as provider finances and healthcare revenue cycle is concerned, the impact is significant. The impression of COVID-19 on the revenue cycle is unpredictable, but providers should handle it in order to fulfill their missions and obligations. Let us discuss different challenges around billing and coding created by COVID-19 on the healthcare revenue cycle.

Billing and Coding

Notable issues in terms of billing and coding could arise from Telehealth and improvements to healthcare regulations. Make sure you have knowledge about what is enclosed by health plans for inpatient as well as outpatient services. With changing rules and regulations, support staff and providers required to be trained and appraised properly. Apart from this, there are other challenges that should be kept in mind.


Most of the outpatient visits has transferred to Telehealth visits. This new trend needs an understanding of the related necessities of a health plan. Telehealth requires knowledge of documentation, approvals, and rates paid by insurance companies.

Changes in the Medicare Regulations

Numerous changes have been imposed on Medicare regulations over the past few weeks. Provider organizations must study these modifications and find out any extra services, which can be billable like, treating patients who are not insured and diagnosed with COVID-19 and offering care with the help of Telehealth. During this critical situation of COVID-19 claim submission and processing is difficult but there are opportunities to collect advanced or faster payment from Medicare in order to increase cash flow.

Remote Billing Work

During this pandemic keeping the billing office working is necessary in order to keep practices and hospitals open for COVID patients needing care. But this could be challenging for smaller organizations with restricted cash flows to cater to the demands of COVID-19. Moreover, if you are not able to shift your billing office remotely then there are chances for hurdles while handling billing and collection responsibilities for employees, who are working from homes.

Apart from the above-mentioned challenges, it is your responsibility to develop an action plan for such kinds of emergencies that will help you to minimize losses and alleviate the revenue cycle.

How to overcome these challenges?

We all have been affected by the impression of COVID-19. To tackle the situation government bodies and payers are supporting for uplifting the revenue cycle and hurdles that are occurred by a novel coronavirus.

Recently, the American Medical Association, (AMA) published that it is accelerating the development of a special Current Procedural Terminology (CPT) code for reporting COVID-19 tests. Apart from this, the Centers for Medicare & Medicaid Services (CMS) has been proactively supporting providers to manage billing and coding aspects of COVID-19 treatment and testing. The agency has recently introduced two Healthcare Common Procedure Coding System (HCPCS) codes, in which laboratories can utilize in order to bill for specific COVID-19 diagnostic tests, like those developed in-house as per the new FDA guidelines. Government initiative and proactive approach towards pandemic will definitely help you to overcome revenue cycle challenges around billing and coding.

Are You Ready To Get Billing?

Want to overcome healthcare revenue cycle challenges? You are at the right place, what you need now is a partner who can finish out the rest of the work and make the technology and implementation just as simple. That’s what the best medical billing company like Medisys Data Solutions Inc can do. If you’re ready to get started, schedule a meeting with our medical billing manager from filling out enquiry form from our website!

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