Top Strategies for Consistent Revenue During COVID Claim Volume Fluctuations

in collaboration with Medusind - Print  | 

Many healthcare systems are seeing another rise in COVID cases. Further fine-tuning of your claims cycle can mitigate the effects of erratic claims volumes on revenue during the pandemic.

After an initial drop in COVID cases after the vaccine became available to those 12 and older, recent statistics say it is again on the rise. USA Today reports, "Daily coronavirus infections (in 2021) are more than four times what the US was seeing on Labor Day last year," an increase of 316%. US Health and Human Services are reporting hospitalizations are up 158% from last year. 

Over 50% of organizations responding to a Healthcare Financial Management Association survey in April 2021 said that claims volume was "erratic and unpredictable" during COVID. Although many organizations made operational adjustments to claims workflows during the pandemic, there are still lessons to be learned to protect your organization from erratic revenue due to claim volume variations.

“Many organizations know what adjustments need to be made to their revenue cycle management,” said Vipul Bansal, CEO and Group President of Medusind. “The challenge is putting that knowledge into action. Now is the time to fine-tune your claims cycle to ensure revenue keeps flowing if or when COVID causes volumes to fluctuate again.” 

Since controlling front-end activities is the most straightforward, Bansal recommends revenue cycle operations fine-tune three pre-submission activities to keep payments on track during the pandemic. 

Avoid unnecessary claims submission delays 

If your organization holds claims several days or even weeks to work around deductibles, evaluate if that strategy works for or against you. Many large payers reimburse electronic claims in two weeks or less, so holding claims too long may be doing nothing besides delaying payment. Additionally, high deductible plans mean that some patients will never meet their deductible in the calendar year. You want your organization to be one of the first bills paid, not one of the last. 

Focus on patient information accuracy

Working through denials is time-consuming, expensive, and frustrating for both providers and patients. Staffing changes, like those due to COVID, can be a leading cause of demographic and verification denials – some of the easiest to avoid. Many healthcare team members aren’t aware that incomplete or incorrect information can have dire revenue implications. Confirm every team member (especially temporary personnel) who works with patient data, both administratively and clinically, is aware of the critical nature of correct information. Don’t underestimate the power of continued education to reduce demographic and verification denials. 

Encourage providers to release charts promptly

Health care workers are doing the best they can under challenging circumstances, and in some cases, it may be reasonable for providers to delay signing off on charts. However, other physicians aren’t as affected by the pandemic. Consider putting a deadline on chart submission from those physicians to balance against unavoidably delayed charts. As with correct patient information, sometimes providers aren't aware of how a seemingly small action, such as releasing a chart, may have broader implications for your revenue cycle.

Strategies to fine-tune operations post-COVID 
Use the right people, process, and technology

Although we may be experiencing another upsurge in COVID, some normalcy is returning. Post-COVID, continued emphasis that the revenue cycle is a team effort that depends on the right people, processes, and technology to be successful. Areas of fine-tuning after COVID may include:

About Medusind:

Since 2002, organizations across the entire healthcare spectrum have leveraged Medusind’s deep expertise and high-quality RCM solutions to maximize revenue, reduce operating costs, and navigate the changing healthcare landscape.

Click to learn how Medusind’s powerful technology and tailored Revenue Cycle Management services deliver outstanding financial results for healthcare organizations nationwide.



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