In addition to the hardships experienced by front-line providers in areas of the nation hit hard by the COVID-19 pandemic, the public health crisis has also placed a significant financial burden on hospitals and health systems.
With sweeping cancellations to revenue-generating elective procedures and widespread economic uncertainty, hospital executives are working to secure the financial health of their organizations. During a recent interview with Becker's, Christopher Hart, vice president of product and strategy with the revenue technology provider eSolutions, discussed the importance of revenue cycle optimization in the era of COVID-19.
Note: Responses edited for length and clarity.
Question: How is eSolutions supporting its provider partners amid the COVID-19 crisis?
Christopher Hart: We know many of our customers are stretched thin responding to COVID-19 and are also strapped for cash. We're working together with our hospital customers every day to ensure they are being paid quickly and accurately for the lifesaving care they deliver. And we are using our proprietary data to ensure providers can find billable insurance coverage on self-pay patients. We have reacted quickly to the CARES Act and our tools allow healthcare providers to easily and efficiently submit claims for reimbursement for COVID-19 testing and treatment.
Q: What kind of increase has eSolutions seen in telehealth claims in recent months? What does this mean for the future of telehealth post-COVID-19?
CH: eSolutions' total telehealth claim volume increased 1,742 percent from January to April. This is a watershed moment for telehealth, as the CARES Act expands telehealth benefits and coverage across the country. Government funds are reducing the cost to implement these new tools and virtual visits are being reimbursed at the same rate as in-person visits. Like the HITECH Act, which accelerated the implementation of electronic health records (EHR), the CARES Act will ensure that telehealth tools are implemented and used widely. As long as the reimbursement rates remain comparable to an in-person visit, more and more physician consults will start (and continue) to be virtual.
Q: What does eSolutions think hospitals should be doing to optimize their revenue cycle during COVID-19?
CH: Revenue integrity is more important than ever before. It's critical that healthcare providers get paid appropriately for the care they deliver. The foundation of a revenue integrity program should be insurance discovery. The best practice is for hospitals to have at least two insurance discovery vendors finding billable insurance coverage on self-pay patients – and the best vendors can find commercial, Medicare and Medicaid coverage on otherwise self-pay patients.
Furthermore, all healthcare providers submitting COVID-19 for testing and treatment of the uninsured must attest they have verified that the patient doesn’t have coverage through an individual or employer-sponsored plan, a federal healthcare program or the Federal Employees Health Benefits program. By implementing an insurance discovery solution, healthcare providers can remain in compliance when submitting COVID-19 claims.