By Dhruv Chopra
As COVID-19 continues to spread throughout the U.S., patients are remaining cautious about returning to practices and are often opting to postpone elective procedures and routine exams to protect their own health and safety. The radiology industry, as a whole, has been severely impacted by this pandemic, as many practices have lost 50%-70% of their imaging volumes.
Many industry advisors also say a sharp increase in revenue is unlikely in the second half of 2020. According to an Healthcare Financial Management Association survey, 89% of 174 hospital and health system executives believe their organizations’ revenues will be lower at the end of 2020 compared to pre-pandemic levels. Almost two-thirds of the same respondents projected their revenues will decrease by more than 15% and a one-fifth of respondents expect decreases of more than 30%.
While there is no clear answer to when COVID-19 will end or if lost revenue will be regained, it is imperative for radiology practices to create an action plan to recover lost revenue. Practices should investigate their revenue cycle processes and find ways they can improve to weather the remainder of the coronavirus pandemic.
Leaders must accommodate the changing industry, especially in its current state with little insight on what the immediate future could look like. Implementing the following strategies can help practices cut costs and improve efficiencies. Practices that navigate the changing industry successfully can prepare for any future highs and lows and have lasting revenue cycle excellence.
Identifying Gaps in Billing Services
Connecting with patients looks increasingly different as the pandemic continues to place the economy in a recession. As the revenue cycle management (RCM) process becomes more complex, it’s possible that gaps in a practice’s process result in significant revenue losses or delays. Possible gaps include incomplete information, missing prior authorizations, or lack of documentation. While successful billing operations will address all of these, there are still some missing pieces that can go unnoticed and can lead to consequent issues and negative financial impact.
Throughout the pandemic, many in-house and third-party billing solutions have raced to determine how to decentralize the operation to homes, straining people’s dominant operations as gaps are found. Proper billing services focus on gaps that can prevent any interruption in remote workflow. Technologically driven, successful RCM processes can automatically focus on these gaps by addressing reasons that are not the fault of the billing function, but rather the payor. This is especially important as the healthcare industry transitions into expanded telehealth usage and physicians explore remote work options.
Enhancing the Revenue Cycle
Now is the ideal time to implement new technologies in your practice. Moving to artificial intelligence (AI) and remote process automation can substantially increase revenue cycle efficiency. Now more than ever, it’s important for practices to enhance their revenue cycles to avoid further complications in this current business decline during the pandemic.
There may be significant revenue opportunities in both outsourced and in-house billing services. Capitalizing on these can enhance the overall revenue cycle. To do this, practices can implement technological solutions that help streamline and automate billing services. Finding a reputable third-party with these solutions already in place can help with implementing them into your day-to-day. While practices are scraping for any revenue they can get, these solutions save practices and administrators a lot of time and highlight any outstanding revenue opportunities.
Utilizing Automated Workflow Solutions
Once the pandemic begins to wane, there is a possibility business will return for practices. That’s why it’s vital to enhance and prepare your RCM process now for environments that could change at any time. Automated workflow solutions can help practices prepare for all the coming peaks and valleys.
Practices can implement advanced solutions that allow access to information with just a few clicks of a mouse, rather than working through claims statuses one by one. These automated processes monitor and manage the end-to-end billing solutions, regardless of vendor, billing system, or solution. Through this, they ensure clean and complete information is obtained on the front-end with real-time, data-driven revenue cycle analytics. The end result is a quicker, more accurate way of managing a revenue cycle.
In conclusion, COVID-19 is putting pressure on healthcare organizations to optimize their workflow and adapt to changing technologies. Providing the right care at the right time and in the right setting has been a goal for practices for many years, and now is their chance to understand what that level of care looks like in today’s fast-paced world.
The healthcare system was stretched thin from the pandemic and the road to revenue cycle recovery will be a long one. Revenue cycle leaders should ensure their organization has a strong financial foundation to weather changes and new methods of delivering care, particularly during this pandemic and the immediate future after it. Enhancing the revenue cycle, identifying gaps in the current system, and preparing for the future with enhanced technology solutions will help radiology practices create a strong revenue cycle that responds to the dynamic and uncertain healthcare industry.
Dhruv Chopra is the CEO of Collaborative Imaging, a radiologist-owned alliance. He previously spent 15 years as an executive with multiple billing companies in the radiology industry where he gained an appreciation for how much physician money is lost due to several inefficiencies.