How COVID-19 Can Change Healthcare Payments
Healthcare institutions have made big changes as a result of COVID-19, including ones that may streamline operating processes and revenue flow. Evaluate these four key challenges now.
The COVID-19 pandemic has upended most day-to-day revenue cycle processes in healthcare. The changing practice environment puts patient payment collection, reconciliation and information reporting under new pressure. Now is the time to consider new solutions that can evolve with new models in patient care.
Handling Block Payments Assistance
The Accelerated and Advance Payments (AAP) program and the CARES Act Provider Relief Fund are just two examples of government-funded provider relief available during the COVID-19 pandemic. However, block payments assistance can carry significant implications for your revenue cycle department.
For example, the CARES Act Provider Relief Fund requires healthcare practices to attest to the number of COVID-19 cases they have treated. Practices must also supply proof that these patients were not billed for the cost-sharing portion of treatment. AAP was structured to recoup advance revenue by offsetting future claim payments. However, this leaves the possibility of an increase in the number of future valid claims that are remitted with no actual funds.
Whether it’s streamlining account structure, information reporting or remittance matching, J.P. Morgan has a number of tools to help bring visibility and control to the movement and reconciliation of funds across your payer mix.
Re-evaluating Claims Management
As part of the national emergency declaration and expanded Medicaid Section 1135 waivers, the Centers for Medicare & Medicaid Services (CMS) has allowed changes to site-of-care rules, patient transfers and telehealth use. Commercial payers are following suit. Denied or pended claims may increase as providers and payers realign billing and payer adjudication systems to accommodate these changes.
Efficiently managing denial letters and payer correspondence should start with an efficient lockbox solution, not with your revenue cycle department. J.P. Morgan lockbox lets you swiftly convert paper payer documents to digital information. This helps provide your revenue cycle team immediate information to resolve denied and pended claims fast.
Making Temporary Telehealth Permanent
After years of discussion about telehealth, COVID-19—and loosened federal restrictions due to the emergency—have clearly forced the issue.
Right now, patient billing isn’t optimized for telehealth. However, as consumers, providers and payers adjust to the new normal in virtual care, this temporary need may become permanent. That will call for additional planning for touchless payment solutions for patients paired with virtual, agile and cost-effective collection solutions in the back office.
J.P. Morgan sees a future where easy-to-use, smartphone-ready patient payment portals link integrated merchant processing with a provider’s accounts receivable platform.
Planning for Long-Term Remote Work
Many health systems are allowing nonclinical staff to work from home on an extended or permanent basis. For systems that have focused on digital interoperability from the patient setting to the back office, that transition may be smoother. But providers in all settings should see adoption of long-term or permanent remote work as an opportunity to move from paper to digital processing.
Online payment acceptance can allow staff members located anywhere to quickly and securely process merchant transactions from patient sites. Advanced lockbox solutions can convert paper-based remittance documents—such as explanation of benefits forms—to network-accessible electronic autoposting files at any time and from any location.
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