4 Tips to Manage Declining Reimbursements in the Wake of COVID-19

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4 Tips to Manage Declining Reimbursements in the Wake of COVID-19


While the final financial repercussions from coronavirus haven’t been measured, we have clear indication from analysts that climbing out of the hole is going to take some time. 

Ambulatory practices, including orthopedics, have suffered some of the worst realities of the COVID-19 pandemic including loss of staff, pay reductions, and cancellation of elective surgeries and office services. The lucky ones that have remain opened have had to restructure their workflow, discover new ways to conduct patient visits, and reassess their payment reimbursement model. 

One of the most challenging aspects of the current practice environment is that information changes constantly. Here are a few helpful strategies orthopedic providers can implement right now to respond better to the unprecedented threats to their business:

  1. Leverage staff who usually perform other tasks to help with cash flow. Once Health Insurance Portability and Accountability Act (HIPAA) safeguards are in place to support a remote work environment, employees can be trained on managing accounts receivable (A/R). They can also learn how to write appeal letters on issues related to benefits and eligibility—one of the biggest reasons claims sit on books unpaid. 
  2. A pause in production can provide an opportunity to increase productivity. Make the effort now to streamline office processes. Re-discover any tools and technologies that are available to your staff but are under-utilized if utilized at all. Training staff now while the time is available sets up for greater success down the road. 
  3. Technology friendly services are key to developing alternative approaches to taking care of patients. Medicare and Medicaid are now reimbursing for telehealth appointments. Insurance payers understand what providers need and are implementing policies that allow practices to offer virtual visits and bill for them. However, be aware that these regulations and codes are changing rapidly so check with payers for specific information on billing patients for telehealth services
  4. There are a variety of financial resources available to help. There is stimulus and recovery funds for private businesses and other entities, including medical practices, through the Coronavirus Aid, Relief, and Economic Security (CARES) Act. For example:
  •  The U.S. Department of Health and Human Services (HHS) is paying out billions in relief funds to Medicare-enrolled healthcare providers. No application is required.
  •  The U.S. Small Business Administration (SBA) is providing low-interest loans qualifying small businesses to help with hardships caused by the COVID-19 pandemic.
  •  The Paycheck Protection Program (PPP), federally guaranteed loans are available to cover eight weeks of payroll expenses with additional amounts that can be used to make payments towards certain business debts, such as interest on mortgage, rent, and utilities. You may not be required to repay these loans.

The availability of funding for these programs changes frequently. The best thing to do is anticipate change and keep monitoring for opportunities to seek financial relief.

In addition, there are other resources available for keeping abreast of the changing business environment and what it means for your practice. It’s a good idea to check the newsroom. Also, both Medicare and Medicaid’s websites are good resources, as well the American Medical Association (AMA) website. NextGen Healthcare offers a COVID 19 resources page as well. 



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