Following COVID-19, healthcare professionals are now equipped to deliver top-notch patient care both directly and virtually. Prior to and after the pandemic, medical billing has always presented its own set of problems. This effort to secure appropriate reimbursement has become more apparent than ever because of the altered billing environment following the pandemic. These are the top 5 observed issues.
Top medical billing challenges
- Increasing quantity of claims being rejected
There were obviously more refused and rejected claims during the pandemic since there was so much financial concern. Every payer routinely updates their billing rules and reimbursement criteria due to the evolving healthcare environment. It is evident that you will have more claim denials if you are not keeping up with these developments. Payers are also modifying their prior authorization requirements.
- Unexpected medical billings
Another issue with medical billing that has arisen since the pandemic is that providers are taking steps to prevent surprise medical billing. It would be challenging to obtain payment not covered by the payer if you didn't have a competent medical billing staff that was delivering precise cost estimates prior to patient visits.
- Reduced telehealth payments
The COVID-19 pandemic increased telehealth services' popularity across the board in the healthcare industry. Despite the widespread acceptance of telehealth and telemedicine, post-pandemic providers have faced particular billing issues due to the inaccuracy of payment and related laws.
Low remuneration for telemedicine was seen as a major deterrent, despite the fact that certain commercial payers and Medicaid programs promised payment parity for telehealth for the duration of the epidemic. Geographical restrictions on medical licenses have hampered telehealth. For medical professionals who are not a part of an in-state healthcare network, cross-state billing is still a problem.
- Patient billing
As was previously said, the COVID-19 pandemic has caused a massive recession that has had a negative impact on health insurance coverage. Over 2.9 million people lost their insurance coverage by the end of 2021 as a result of employment losses brought on by the outbreak, according to a report. Additionally, millions more people may decide not to use insurance benefits provided by their employers.
The payer billing strategies and payer mix would significantly change as a result of this paradigm shift in insurance coverage. The rising popularity of high-deductible health insurance has caused service providers to turn more of their attention toward self-pay options. A hurdle would still exist in fully collecting patient payments given the growing popularity of high deductible health insurance.
- Unqualified billing professionals
You will require skilled medical billing staff due to the numerous modifications in billing and coding for your field of medicine. You cannot expect your front desk staff to manage medical billing for your business effectively. Prior pandemics saw larger patient volumes, and practitioners just submitted claims without following up on rejected or denied ones.
You cannot afford to lose even one claim to rejection or denial given the altered billing environment brought on by the epidemic. Finding knowledgeable billing and coding specialists who are familiar with your medical specialty's billing requirements will guarantee your practice's financial viability after the pandemic.
VLMS Global Healthcare is a leading provider of comprehensive medical billing and coding services. Our medical specialty-specific billing and coding specialists will make sure you are fairly compensated for all provided services.