HealthStream regularly hosts in-person and virtual meetings among customers to encourage connections with one another and enhance the value of using our solutions. These meetings involve sharing best practices with one another, and often customers learn about industry issues and how HealthStream can help solve them. A recent virtual meeting of the Revenue Cycle Special Interest Group focused on how healthcare organizations are adapting to the demands and necessities of the COVID-19 Pandemic. HealthStream staff and customers were joined by Revenue Cycle solution experts from nThrive education. Below are three major trends in healthcare Revenue Cycle operations that our customer and partner experts covered during that session.
Functional Transitions within Healthcare Revenue Cycle
One effect of the COVID-19 Pandemic has been to alter the kinds of care many organizations are finding themselves providing to patients. With a greater focus on Emergency Department and inpatient care, the coding knowledge for these areas is in much higher demand. Healthcare providers need access to Revenue Cycle education that will assist their staff in roles that are needed now more than ever before. nThrive’s Transitions Program is an ideal solution for bringing staff up to speed for new roles. Individuals that need to switch responsibilities are offered a base knowledge assessment, and then are provided with a list of courses and practice opportunities as preparation for the new role. Readiness of every candidate to perform effectively is confirmed in a final assessment. This assessment allows organizations to respond to their altered patient and payor mix while ensuring Revenue Cycle functions are keeping up to date with how the pandemic is changing healthcare.
Revenue Cycle Implications of the Burgeoning Use of Telehealth
Major increases have occurred in the use of telemedicine and telehealth. This has come about from Medicare’s Section 1135 Waiver, which allows for covered home-based visits for telemedicine. The providers are not just physicians and nurse practitioners—they include psychologists, therapists, and licensed clinical social workers. The root of telehealth’s rise lies in the reluctance of patients to visit healthcare facilities due to COVID-19 infection fears. Many people are now using this option for short check-ins and regular e-visits, which are now paid at the same rate as in-person visits. After Medicare’s approval, some other payors are following suit.
Another Revenue Cycle issue for telehealth involves audits. Though they are not currently being done, there’s no reason to think this will permanently be the case. Coding problems may occur if the provider is a nurse or physician assistant. It is extremely important during every telehealth visit to get consent from the patient and communicate that the session involves a charge.
Patient Access Needs Have Increased for Emergency Departments
As Emergency Departments have become the center of activity during the COVID-19 Pandemic, many organizations need to shift patient access employees to that environment. With the drop off in elective surgeries, hospitals have had to shift staff to those areas with a greater need. However, there are special considerations for patient identification that apply in the emergency care setting. Whereas typical registration may involve as many as 17 data points, that in the ED may be limited to as few as three when patient safety is an overriding concern. Imagine the potential for patient misidentification and duplicate medical records as the visit starts with drive-through testing from an automobile. The good news is that registration can be completed from the bedside, once a patient is safe and stable. For patient access training to prepare staff for the ED, distance learning and competency assessments are available from nThrive. One of the customers in this meeting offered that her organization started every new Patient Access employee in the ED, as a “trial by fire.” Another offered that her organization cross-trained patient access staff across many care environments for staffing flexibility as patient volumes fluctuated.
All staff with Patient Access must perform effectively to ensure the success of the revenue cycle in its entirety. With the shift toward high-deductible health plans and the growth in newly insured individuals, Patient Access is faced with communicating and collecting increasingly larger amounts for which patients are financially responsible. In addition to patient communications, these employees must fully understand insurance plans, coordination of benefits, medical necessity, ABNS, and the importance of the demographic and insurance information they collect and record. nThrive Education provides Patient Access employees with the necessary training to help ensure that patients understand their financial obligations and payment options. This information, when communicated properly, increases payment collection and reduces days of AR.
PLEASE NOTE: The information in this blog post was considered current at the time of its publishing, 06/05/20. However, the COVID-19 pandemic is an ever-evolving disaster due to new findings, data, and availability of resources. Please refer to the CDC website for the latest detailed information when you need it.