With changing technologies, such as telehealth, ensuring minimal revenue cycle interruption during the COVID-19 pandemic presents new challenges for physicians and their organizations. Healthcare providers seek guidance about what code to use, what to include in their documentation and what place of service to use — all while navigating an evolving reimbursement and regulatory landscape.
During a May 14 webinar hosted by Becker's Hospital Review and sponsored by Ensemble Health Partners, Julie Appleton, vice president of revenue cycle coding with Ensemble, provided five techniques healthcare organizations can use to support physicians and ensure effective claims processing to maximize collections.
1. Establish a collaborative task force with centralized leadership. This task force involves all physician revenue cycle team members, including IT, compliance, coding, and managed care. Ms. Appleton said members help anticipate effects of changing regulations within systems, across the provider network and among the physician revenue cycle departmental workflows. She cited Ensemble's work as an example. "We needed to streamline our resources [for clients] to succeed, so we capitalized on our team's strength and we created multiple task forces that rolled up to the leadership team," said Ms. Appleton. "We looked at workforce solutions for the clinic environment. We [also] collaborated with information technology because we were having to make system changes frequently and rapidly and to prepare for the potential outcome."
2. Ensure consistent communication across the physician revenue cycle team. Ms. Appleton recommends consistent communication internally across the physician revenue cycle team as knowledge is gathered and information changes. For example, the Ensemble team huddled each morning and afternoon, in addition to multiple meetings throughout the day.
3. Ensure consistent communication externally with payers. Ms. Appleton recommends consistently communicating with payers and other resources to navigate changing reimbursement and regulatory rules.
4. Establish a centralized source of truth for information. Ms. Appleton suggests having one central site for COVID-19 issues, resources and changes. Ensemble created a centralized workspace with teams, and documented decisions as well as the guidance used in making them. "Everybody could refer to that document and know where we were at that time, why we did what we did and where we had moved onto, because we needed to remember why we were on the path we were on and why we changed course," said Ms. Appleton. She said all coding guidance came from one source, and the coding team became the "source of truth" for information relayed to clients to ensure accurate coding.
5. Provide continuous education to physician revenue cycle staff. Ms. Appleton said this education should be immediate and continuous for new processes. She also recommends ensuring an avenue for team members to ask questions.
These materials are for general informational purposes only. These materials do not, and are not intended to, constitute legal or compliance advice, and you should not act or refrain from acting based on any information provided in these materials. Please consult with your own legal counsel or compliance professional regards specific legal or compliance questions you have.