Since the global outbreak of the novel coronavirus, many health systems have seen a decline in normal patient services, leaving gaps in revenue. In light of the national public health emergency, Congress has passed legislation designed to support both citizens and hospitals during the pandemic—but without a thorough understanding of procedures and requirements, facilities risk missing out on reimbursement entirely.
The Coronavirus Aid, Relief and Economic Security (CARES) Act was signed into law on March 27, 2020, and it will be in effect through the end of the public health emergency, which was recently extended through October 22, 2020. One of the CARES Act’s key impacts is that it eliminates cost sharing for ensured patients who are tested and treated for the virus. It also has provisions to provide coverage and support for telehealth services and pay hospitals for the care of uninsured patients through the Health Resources and Services Administration (HRSA) program.
In the face of all these changes, facilities must be careful about coding claims properly in order to pursue sufficient reimbursement from the correct entities. Otherwise, they could end up writing off incorrectly allocated coinsurance, deductibles, and copays.
Take the real-life example of one facility that had a patient test positive for COVID-19. Several days after the diagnosis, the patient presented at the hospital with a cough, fever, and a rash—all symptoms of the virus. However, the hospital did not perform a new test, and the ailments were not assigned COVID coding. Ultimately, the primary payor paid the claim, leaving the patient with a coinsurance amount due—and the hospital wrote it off instead of pursuing it further.
If this facility had rebilled the aforementioned claim with COVID coding, the coinsurance would not have been necessary—and the hospital would have been paid in full for the entire claim. This is just one example of a scenario taking place in millions of health systems across the nation.
How many claims has your facility written off instead of billing to get a payment that eliminated patient cost share? Your team may not have the time or the resources to pursue all these claims to reimbursement—but at Aspirion, that’s our number-one priority. Contact us today to start recouping your revenue.