Coronavirus and your medical practice revenue

March 12, 2020

Commentary by Vachette and Stark Medical Auditing CEO Mick Raich

With the current travel restrictions and changes affecting the country due to the new coronavirus (COVID-19), the question comes to mind: how will this affect my practice?

Medical billing companies are companies with large numbers of people and many of them have basic cubical farms with 200-1000 people in the same building.  This may be prime coronavirus territory.  Imagine if your billing company decides to have everyone work from home like some major companies or universities? 

For starters, many of these employees cannot do their job from home as they do not have access to the critical PHI data.   Although many companies have work-at-home CPT coders, they do not have this access for people posting payments or working the accounts receivables.  So, these payments could literally go unposted as employees are quarantined at home. 

Additionally, many billing firms outsource their work to Costa Rica, India, or Indonesia.  So far, these countries have a very small virus footprint.  But, if this becomes a worldwide issue, expect the large companies to institute a quarantine policy.  The bad news is the work may not be getting done, which can be compounded by the fact many insurance companies have large amount of staff in these countries also.  The worse-case scenario may see both your billing company and some of the insurance companies have staff off site for a period of time. This would slow your payment processing exponentially and lead to a decline in revenue.

With these changes in the queue, there may be some telltale signs to look for: 

First, watch your record of daily charges. For billing to happen charges have to be billed out to your payors.  Monitor this daily and chat with your billing company about this work flow.

Then, look at your record of daily receipts.  This simple report shows how much is posted each day into your payment accounts.   

Next, look for your accounts receivables to rise.  If payments are waiting to be posted then secondaries and appeals will be waiting also. 

Track these metrics closely; they are basic billing reports. If you have questions about getting these reports feel free to contact us directly at 517-486-4262.  We will help you work with you billing staff or service to get these reports lined up.    

Several questions come to mind when this scenario plays out.  For example, will insurance companies offer a dispensation if billing slows?  Will they waive their filing limits or appeal limits?  My bet is the insurance companies will use this as a revenue event for them and see this as a way to increase denials and increase their profits.  Remember, there are rules for payments and if your billing entity has delays in billing or appeals then per contract, many insurance companies do not have to pay you for your services. 

In summary, we are still in the what-if phase of this world drama.  The bottom line is your practice or lab will continue to have expenses throughout the process as this plays out, so you will still be culpable to pay your bills and your employees.  This means you have to have correct billings.  Look for these trends as a way to tell if things are being processed smoothly. 

  • Track your charge capture, make sure bills are getting out the door.
  • Track your payments to make sure money is being posted daily.
  • Follow your account receivables very closely.

Measure missing money, charges and payments.  If there is a delay in billing or collections you should be able to recoup this money in time.

Make sure your billing entity makes up this difference.  Don’t let billers or insurance companies use this as a reason to keep your money.  Remember, these firms will be looking to maximize their revenue off of this change. 

This virus will pass and things will return to normal, so be aware of the issues during this challenge and don’t let your lab or practice lose money.  If you are concerned about this and want to chat further contact us here at Vachette and Stark Medical Auditing.  We will be your watchdog over your revenue.  Contact us at 517-486-4262. 

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