Reimbursement Optimization for Covid-19 Care

At first glance, the new billing changes precipitated by the Coronavirus (Covid-19) crisis appear to be straight forward and simple to apply.  There are only a handful of coding changes – what could possibly go wrong?  Unfortunately, a myriad of things can go wrong because the changes have to be coordinated carefully with providers, clinical staff, lab teams, coders, billers, and supporting electronic medical systems.  Coronavirus telemedicine screening services have specific compliance conditions that can easily be violated.  Getting any of these directives wrong can result in major revenue reimbursement issues such as underpayment for services and delayed payments at a time when cash flow is at its most vulnerable level.  In addition, extra labor is often required to resolve issues.  Problems like these can and will occur because most organizations are stretched to the breaking point and do not have the time to determine the adjustments that are necessary to ensure accurate and efficient billing and reimbursement.

The clock is ticking…  If your staff is stretched and unable to take on the effort to align itself, or lacks the understanding of what is involved, Quality Healthcare Partners (Quality) can help.  Quality offers a rapid-response service that performs a comprehensive assessment of your organization’s procedures for processing COVID-19 claims and introduces reimbursement optimization that will more than pay for itself.  Here is our approach to performing this service:

  1. Plan pre-claim review.  We will perform a baseline assessment of your organization’s COVID billing processes starting with an audit of a sampling of claims.  Our consultant will review the UBs, the itemized patient bills, and the patients’ medical records associated with the claims.
  2. Optimize revenue with face to face documentation compliance.  Simultaneously with performing the audit, we will interview select members of the departments that record the information that is used in preparing claims.
  3. Within days, we will report our findings and estimate their impact on your revenue stream.  We will also recommend immediate corrective actions and longer-range process improvements.
  4. During training, we will provide knowledge-based instructions and process improvement advice. 
  5. Approximately 30 days after the staff training and process improvement guidance, we will perform a follow-up audit to assess progress and to offer recommendations for continued success.

Quality can perform this service remotely and complete this engagement in 30 to 90 days depending upon the size of your organization.  Within days your organization you will begin to realize significant improvement in your reimbursement rate.  Our consultants are experienced revenue cycle specialists, possessing certifications and in-depth knowledge of coding, clinical documentation, medical records analysis, and the improvement in workflow efficiency.  They can begin working immediately.