Tuesday, June 18, 2024
HomeHealthcareNavigating the complexity of health insurance and reimbursement outside of the pandemic

Navigating the complexity of health insurance and reimbursement outside of the pandemic


As of March 2021, more than 53 million Americans Fully vaccinated, we can remain cautiously optimistic as we prepare for the next phase of the COVID-19 journey. Unfortunately, for pharmacists, the vaccination program has exacerbated many of the challenges of the past 12 months.The patient may be able to inject for free, but someone has to pay for it—and Getting reimbursement proved to be a major painThe complicated billing process, additional billing audits and a lot of extra paperwork, rejected claims and slow payments are not unique to pharmacies that help the United States get vaccinated.

As the coronavirus pandemic continues to disrupt the insurance industry,

Grasping the lost dollar is challenging.

For other providers, medical reimbursement is not so simple: loss of extensive coverage and unpaid care Hospital revenue cycleAs the coronavirus pandemic continues to bring chaos to the insurance industry, obtaining lost dollars is challenging. Providers must find ways to quickly and accurately determine the coverage status of each patient to minimize bad debts.

Navigate the complex world covered by post-COVID healthcare

What is the prospect of reimbursement after one year?

  • After a long wait, the elective program is back. But the surge in the number of patients means that providers must remain vigilant to track coverage. The process of doing so must be streamlined and precise.Increase production capacity Verify and check coverage No tedious paperwork is required.
  • Patient intake is under pressure. Due to selective services and vaccination programs (although not always to their usual facilities), more and more patients are entering the gate. COVID-19 has not disappeared, and with the emergence of the peak of infection, safety remains the top priority. Obtaining sufficient insurance information in this situation is no easy task.Run Automatic coverage check Once the patient arrives, face-to-face contact during admission will be minimized to avoid delays.
  • Patient interview and collection staff are overburdened. When employees operate remotely or in an environment far away from society, manual inspection is difficult, and patient information may be incomplete. Automatic cleaning at your own expense can help deal with the quantity. Tools with built-in reporting capabilities can also provide insights on workflow and productivity to help identify opportunities for faster processing of claims.
  • Insurance companies do not always cover new digital healthcare technologies. TelemedicineIt is a life raft during COVID-19. Compared with medical insurance and Medicaid, private insurance companies tend to underwrite less frequently. Coverage checking must take this into account to avoid errors and wasted time.Providers should choose tools that can scan payers for telemedicine coverage updates Avoid unnecessary delays or rejections.
  • Employment levels may rise again, but as patients start new jobs and develop new health plans, tracking coverage remains a challenge. In addition, checking Medicare coverage during the process of changing codes and agreements can be time-consuming and laborious.Third-party resources, such as Coverage discovery You can find all coverage options and ensure that the correct bill is paid to the correct payer.

Use Coverage Discovery to find lost dollars

Hospitals, pharmacists, and other healthcare providers cannot continue to lose money when every dollar is needed to prepare for the “post-COVID-19” period.

Experian Health Coverage discovery It is a proven system that can quickly and easily track missing coverage to avoid unnecessary revenue loss. It uses billions of data assets and intelligent confidence scores to sort out multiple government and commercial payer accounts to maximize operational coverage. Workers can trust the output and focus their attention where they really need it. By making coverage identification more efficient and accurate, this is a boost for providers who need faster reimbursement.

contact us Learn how to easily integrate Coverage Discovery into your revenue cycle so that you can maximize your reimbursement in the coming weeks and months.



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