2 ways to work with payers during the COVID-19 crisis
/ April 28, 2020

2 ways to work with payers during the COVID-19 crisis

Waystar is currently working to expand and introduce resources for those in healthcare dealing with the COVID-19 crisis. In this series we’ll explore what you can do to work with the three groups most vital to your organization: patients, providers and your people. Check out parts 1 and 2 here.

COVID-19 has completely reshaped the healthcare landscape. Telehealth appointments have surged. The majority of elective surgeries are being postponed. And rules and regulations related to the pandemic continue to fluctuate. As we settle into the new normal we’re starting to get an idea of what the future will look like, with researchers indicating we’ll be dealing with the impacts of the crisis for at least a year

Payers now face the challenge of contending with those fluctuating rules and regulations, new or changing clinical codes and a huge increase in the number of phone calls and requests from providers. Long hold times have become a frequent complaint, while claims tracking becomes even more challenging as the processes around it have completely shifted.

Like providers and patients, payers are hard at work keeping up with these changes at the same time as their teams’ transition to remote work environments. So, what can you do to help tackle these challenges and strengthen your organization’s relationship with payers?

1. Monitor claim processing

As CMS releases updated regulations and new codes to identify COVID-19 patients, payers have to respond with updates in order to process these claims. Tracking claims and understanding setbacks in processing or remittances is now even more critical to managing financial performance.

Ensure claims are processing and paying correctly by using dashboards and scorecards to monitor payer performance and processing. You also want to adjust reporting to tag COVID-19 and telehealth outcomes to gauge potential issues. These tools will help you coordinate with payers on process improvement and status updates while pinpointing any additional policy changes that might need to be taken into account.

2. Automate and streamline

Now more than ever, your RCM platform needs to ensure clear lines of communication, ease of reporting and a simplified approach to process improvements. Automating your claim status checks can reduce the number of manual tasks and calls you need to make to payers (simultaneously helping to reduce their hold times—a win-win).

An automated solution makes the task of managing attachments much simpler, while electronic submission can reduce wait times and lessen a team’s printing needs. An effective solution will also use eligibility checks to cut down denials and increase payments on first submissions. Finally, with proper automation, you can focus on analyzing denials to reduce rejections and determine any additional up-front custom edits that are needed.

The wrap up

If you’ve read through our full COVID-19 series, you may have noticed a few key strategies. Automation. Clear communication. Coordination. Efficient monitoring and detailed status updates. These are not necessarily new tools and strategies, but in the face of this pandemic they’ve become more vital than ever.

In the face of uncertainty, it’s critical we concentrate on the things we can achieve and the actions we can take to help make everyone’s day a little easier and less stressful. With these tips and tools, we hope you’re able to do just that for your people, patients and payers.

Want to learn more? Check out the Waystar webinar, Supporting Your Stakeholders.

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