With COVID-19 now sweeping the world and leaving thousands of people in need of urgent medical attention for respiratory and virus-related symptoms, it’s no surprise that healthcare is under strain unlike anything ever seen in the past few decades. While for doctors, nurses, and medical professionals this change will be right under their noses, for medical billing companies dealing with Medicare and other aspects of medical insurance, these changes may be far more unexpected.
So for the workflows of medical billing, what kind of changes are likely to be cropping up due to Coronavirus? While ventilators are what everyone is talking about on the news, there are far more hidden or lesser-known costs to receiving treatment for this condition – and it pays to understand the hows and whys when dealing with concerned members of the public, or even insurance companies.
Here are just some of the medical costs associated with patients undergoing treatment or receiving care for COVID-19:
Patients currently will not have to cover the costs of Coronavirus testing, as specified by the current government response act to Coronavirus. This means that insurers will have to cover the costs in full the services and items utilized to complete the testing – currently, most likely drive-through or roadside swabs. However, the provider of the test may be able to charge a one-time cost to patients for their testing, whether or not they are confirmed as negative for the virus.
While for many with Coronavirus, the recommendation is to stay home and rest, for those with additional medical needs or complications, further consultations may be required to get the care they need. This is especially the case for individuals with complex health problems that are pre-existing, or those that are more susceptible to the virus. Which could mean anything from consultation with heart or respiratory specialists to gaining the opinion of someone knowledgeable about their existing conditions to provide the best standard of care.
In the case of those in need of an urgent evaluation from, for example, an infectious disease specialist, this may result in out-of-network cost, which can lead to further medical billing for the individual. Similarly, additional charges may apply for those that need specialists due to pregnancy or for children that may have caught the virus – all worth watching out for when billing individuals for their ongoing care or completed medical support.
Out-of-network doctors and providers
In the event of an emergency, like our current pandemic situation, it’s all hands on deck. This means private doctors, providers, and medical professionals offering support in hospitals and clinics that would otherwise be managed by in-network physicians. As such, this may result in additional charges for the patients under that individual’s care, depending on the treatment and consultation they receive from that specific doctor or care they receive from a particular provider.
Equipment and medical treatment
While there is no known cure or vaccine for Coronavirus, doctors are still working to provide the treatment and care needed to keep people alive until each person can fight off the virus within their bodies. Ventilators are, of course, an expensive form of treatment that a small percentage of patients may need to breathe for them, while oxygen and other breathing support systems are also in use across the US to provide useful and adequate treatment to anyone sick with the virus.
For those with moderate symptoms, medication may be prescribed to ease breathing, as well as to bring down a fever quickly and effectively. Attending the ER itself is part of medical billing, and with paranoia at an all-time high, that means certain people are attending two to three times a week to access testing – all of which results in more extensive medical testing.
Further changes on the way?
As we further understand how to treat and manage COVID-19, it’s likely that we will see even more variation in billing compared to today – especially once we’ve got a firm and scientific understanding of what works and what doesn’t. As of now, medical billing is likely to be busier than ever for the next few months to a year. And that figure may continue to explode depending on the practicality and efficacy of the current lockdown.
For medical billing, understanding trends and sudden spikes in particular medical areas is always notable – and it’s likely we’ll never see a spike again that’s quite as high as it has been these last few months. For billing workflows, this may mean a higher backlog and increased challenges. But it will also be a valuable learning experience for how to manage and identify such explosive changes in the future.
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Also, check out our article on 10 Things you Need to Know About the Coronavirus and Medicare & Understanding the Medical Billing Process as a Patient.
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