Databound clients are using automation to cope with the changing needs in the healthcare revenue cycle and saving thousands of hours of work.
June 30, 2020
Automation that provides the flexibility for users to adapt their processes quickly to changing conditions has proven to be a vital tool in helping healthcare business offices cope. Recently, we held a virtual discussion with a group of clients, each leaders in patient financial services and IT, about using automation in response to COVID-19.
During this discussion we learned how their work has changed and how automation can help healthcare professionals navigate through these new challenges. The clients we spoke with, including those in some of the country's hardest-hit areas, are using EMUE creatively to help get a significant amount of work done, even while most of their staff are working remotely.
Below are some examples of how these healthcare leaders are using EMUE automation to address the changing landscape of work.
Adapting to new work
A big challenge for business offices is accommodating the new reimbursement rules from CMS. Because hospitals can request reimbursement for COVID-related testing and treatment, revenue cycle managers do not want to seek out-of-pocket payment collection from the patient.
As a result, hospitals must change how they process and bill these encounters in order to receive payment for COVID-19-related services.
Guarantor collection holds and tracking payments
For some healthcare facilities, these affected encounters can number in the hundreds or thousands per day. Several facilities that we spoke with are using EMUE to put these encounters on guarantor collection holds while they await payment from Medicare or the private insurer. Revenue cycle managers are also tracking payments on these encounters with EMUE automation.
Separating COVID and non-COVID encounters
It is not uncommon for a COVID-19 patient to also receive treatment for non-COVID related issues to which the new rules do not apply. In these cases, our clients shared that they are either manually separating or automating out the non-COVID elements to be handled and billed as usual.
Pricing is a concern for COVID-19 related codes and DRGs. Pricing has been changing frequently and it has been hard for administration to keep up; they are finding under-paid and over-paid encounters, and they intend to use EMUE automation to process balance adjustments.
Preparing for action
Our clients also expressed the need to appropriately prepare for the changing healthcare work environment while being proactive about managing staff burnout.
Employee antibody testing
As a part of many return-to-work policies, hospital facilities are adding their employees as patients so that they can institute antibody and other testing. These tests must be scheduled, performed, and tracked – a massive burden for large hospital systems with tens of thousands of employees.
To help alleviate the burden on staff, EMUE is being used at one large healthcare system to set up 70,000 employees in the EMR and patient accounting. It will then schedule employee appointments for antibody testing.
Integrating Telehealth data
Nearly all the facilities in our group were either evaluating or expanding their use of Telehealth services. All of them were considering systems that were separate from their patient accounting system. They were expecting to use EMUE to support integration between systems, anticipating that the integration options available from the vendors would have some critical limits.
Setting up and deactivating surge spaces for treatment
Most provider facilities had to set up surge spaces for the testing and treatment of COVID-19 related patients. EMUE automation has been a great tool for the task of setting up and testing new surge locations in clinical and patient accounting systems. The hospitals we spoke with are waiting to see if they experience a "second wave" of COVID-19 cases before deactivating their surge locations, which they also plan to do with EMUE.
Recording provider credentials
Finally, as providers have come back into the workforce to help with the surge, facilities need to record current provider credentials. This can be a time-consuming task and involves going to websites to download PDFs and other documentation. At least one hospital we spoke with intends to use EMUE to automate this process and save time.
Avoiding staff burnout
Some of the country's largest health systems and individual community hospitals are leveraging automation to keep their revenue cycles on track and to ensure they are communicating effectively with patients, billing them correctly the first time. We sampled 8 Databound customers on our automation platform that have created processes in the past few months specifically to address COVID-19 related work. Those process operations have exceeded an estimated 6,000 hours of work performed by EMUE. This has freed staff to focus on more urgent and complex matters and avoided the cost of hiring temporary workers to deal with the increased workload.