Christopher Fisher, CRCP-I, maxRTE Business Development Director

Like many industries, healthcare has become a victim of COVID, sustaining great economic injury. We spoke to one organization that was losing a million dollars a day due to COVID. And even last Fall, with elective surgery resumed, losses continued.

Beyond absorbing bottom line blows, clinical providers pivoted in order to serve patients both inside and outside of traditional practice venues. While televisits had been available, COVID drove a dramatic upswing in patient acceptance of telehealth as a legitimate form of interaction with medical professionals. This trend has gained exceptional steam in treating mental health and addiction issues, which the pandemic has fueled.

So after a year of COVID, professionals recognize that telehealth is here to stay, according to the professionals we’ve been in contact with. They’ve also shared the challenges they faced as a result of not being prepared for the telehealth surge with a registration process for insurance verification.

Essentially, the lack of a process for updating insurance information prior to the telehealth appointments results in:

  • charges posted to “self-pay”;
  • uncollected co-pays that feed self-pay dollars;
  • and increased denials (policy termination, policy no longer in effect, etc.) that lead to timely filing denials.

So what can be done to address this challenge? According to the following professionals, technology-based systems will help:*

Heather Nelson, senior vice president and CIO, U Chicago Medicine

“From my perspective, the best way to ensure telehealth remains a key part of healthcare delivery is to ensure the reimbursement and payment methods stay in place and even be enhanced as more and more patients want to have access to this model of care. We need those blanket waivers issued by CMS during the public health emergency to be made permanent. If we keep extending a few months at a time, it does not allow healthcare systems the confidence that we can continue this delivery of care, as well as invest in supporting technologies and operations.”

Ash Goel, MD, senior vice president and CIO, Bronson Healthcare (Kalamazoo, Michigan): “Integration of telehealth technologies into a broad spectrum of offerings such as acute care, chronic care management, remote monitoring, social management, employee and employer-based services with a business model that supports this is essential. The technical platforms have to evolve to become flexible and yet integrated into existing EMRs to minimize friction, understand the patient experience and be UX design-centric.”

Learn how healthcare organizations are using technology for insurance eligibility verification and insurance discovery for self-pay patients.

 

*As seen in Becker’s Health IT, 2/22/2021