Have any questions? Feel free to contact us:
(218) 203-0510
Posted by: Admin
Category: Blogs

New Medical Billing Payment Models for Emergency Care during COVID- 19 Situations

The Coronavirus upheaval has brought great sorrow to the world in terms of economic, social, physical, and psychological disruptions. As consumerism has seen a low, there have been large-scale changes in U.S. equity prices. Considering these factors the healthcare market has seen exponential growth in medical billing expenses to contain this vicious strain of COVID-19. The healthcare market is facing an overhaul and pushing for American perspectives to change in terms of care over costs.

The worldwide pandemic has proven to be a dynamic catalyst for health care changes. It has further created revenue cycle management challenges that have highlighted greater patient financial responsibility and health care worker allocation tremendously. Medical billing and coding service providers have seen a superior business growth during this health emergency. As the global lockdown has hit the U.S. healthcare industry by epic proportions government officials have announced greater support for health care providers and patients.

The Institute for Health Metrics and Evaluation (IHME) has highlighted the need for more intensive care units (ICUs), hospital beds and ventilators during the coronavirus outbreak. With a constant surge in COVID-19 deaths and treatments medical billing and coding companies have helped in micromanaging the volatile infrastructure of revenue cycle management for health care providers with enormous finesse.

The novel Coronavirus has increased the workload of health care professionals and has called for a proactive approach to treat this malady. The health care personnel need to take self preventive measures to perform many diagnostic testing and treatment procedures for the affected.  Avoiding financial calamity and sustenance of a growing health care facility is the top priority for all small and large medical facilities. According to Business Insider the Coronavirus Aid, Relief, and Economic Security (CARES) Act will give out $1,200 to adult taxpayers earning $75,000 or less.

Hike in Coronavirus Cases Could lead to Medical Debt

The Human Rights Watch is making sure those COVID-19 patients whether insured or not receive the treatment needed without bias. Keeping in mind that, the huge financial crisis poses a threat to many communities and their loved ones.  A few cases of Coronavirus patients received over $30,000 in medical bills and have caused a huge frenzy according to America’s Health Insurance Plans. Uninsured U.S. citizens can be billed at higher rates than others which is quite alarming. Medical billing pricing has seen an all-time high all over the U.S. While private insurances have waived off usual co-deductible and co-pays for testing but not in terms of Coronavirus medical treatments. As observed lately people with insurance could pay up to $1,300 for Coronavirus treatment.

Cases of COVID-19 have led to Surprise Medical Bills

The term “Surprise Medical Bill” creates a feeling of great anxiety for more than half of the population in general. Inadvertent health care treatments that are provided by an out-of-network provider can have a devastating effect on the fragile minds of patients during the Coronavirus pandemic. As health care expenditures might take a hefty toll on Coronavirus patients who are facing budgetary constraints, it will impact their future financial savings as well. EHR integrated medical billing and coding software has helped tremendously in tracking medical patient history, and clinical reports. The role of insurance carriers dealing with this challenge is immense as they are the ones who verify the medical necessity and relevant health care paperwork before releasing reimbursements to providers. Almost 16% of inpatient health care assessments cause at least one out-of-network charge on an average, which can change as per different State rules.

Out of Pocket Hospitalization Costs

As cited by an independent non-profit FAIR Health database 66 million to 198 million Americans may become infected with the novel Coronavirus that causes COVID-19. With this statistic in mind uninsured American citizens can be in a tight spot due to exorbitant Coronavirus health care expenditures with nearly $75,000 in medical billing if tested positive for the lethal virus. Diagnostic medical billing and coding expenses for Medicare and Medicaid policyholders with symptoms of pneumonia are growing rapidly. Keeping this in mind CMS (Centers for Medicaid and Medicare) has announced two new HCPCS codes (Healthcare Common Procedure Coding System) codes for testing and billing for COVID-19 cases. Both hospital services and emergency room checkups for Coronavirus by out-of-network providers are leading to huge medical bills. This may also include general facilities fees as well.

Private Health Insurance coverage Payments

Families First Coronavirus Response Act (FFCRA) refers to the emergency period declared by HHS Secretary’s public health emergency declaration from January 27, 2020. Physician billing is being outsourced to professional medical billing and coding service providers to assure more precise quality assurance standards. There have been mounting cases of Coronavirus cases and treating complications related to it ever since. More than 80 percent of people having job-related insurance plans have deductibles and that can roughly add up to a payment of $1,655 according to Health Pocket. Private health care plans might cover most medical services but leave out deductibles all together. This means thousands of dollars to pay for medical treatments related to coronavirus with just a few exceptions.

Eligibility Requirements for COVID Testing Groups

Coronavirus patients are required to have basic requirements like being a U.S. citizen and possessing a Social Security Number (SSN). Non-immigrants have restrictions on payments for medical services rendered according to the Federal Financial Participation (FFP). The COVID-19 testing eligibility group classification simply implies that diagnostic testing should be done to detect the presence of virus amongst a group of folks to determine who can be returned to work with just one test. Patient coordination and care through e-prescribing have helped ascertain Coronavirus cases promptly. This is a global way to assess strategies to normalize work mass confinements all together.  The idea of serological tests can’t pin down a population of millions but can help in identifying ways to minimize the spread.

Types of Coronavirus Testing and Their Payments

U.S. Government Officials have announced free testing for COVID-19. Testing for Coronavirus is leading the path to further research into how the virus spreads and its highly contagious nature. This can minimize high exposure to the virus and serve as a primary tool to help slow down the spread. It helps in tracing the quarantined virus carrier and the number of people that the patient has had proximity with. It also helps in choosing the workforce strength that would be required to perform diagnostic testing, treatments and screening for COVID-19. Medical billing software features like claims management, patient eligibility reporting, and financial benchmarking are helping in accurate Coronavirus testing. The two types of tests for Coronavirus are to first check for positive results confirming a patient has the virus. Secondly testing for antibodies to determine any past exposure to the virus that is hidden. They can be called a polymerize chain reaction (PCR) test and antibody test. As there are no costs for testing for Coronavirus it serves as a bit of relief for patients based in the U.S.

GreenSense Billing has state-of-the-art healthcare solutions paving the way for exceptionally managed care. Our revenue cycle management tools are both cost-effective and efficient to support specialty-based health care. We have a team of highly professional and reliable medical billing and coding experts that maximize your revenue and ensure operational excellence.


Leave a Reply

contact us