COVID-19 — the “novel coronavirus” — may still be new, but the challenges it has presented, particularly for healthcare providers, feel like an age-old problem. Administrative burden has plagued healthcare and increasingly pulls, distracts, and detracts clinicians from their real mission: providing best-in-class care to patients.
COVID-19 has changed the way healthcare works, at least temporarily, including the way it administratively operates. The last thing providers should be worried about right now is paperwork and administrative tasks. On a normal day, these tasks — electronic payment and remittance advice enrollment, credentialing, payer onboarding, and more — can be a burden. But these administrative tasks are essential to keeping the business of healthcare running, now more than ever.
In the current environment, more paperwork is being created at a time when there is less time for it.
The disruption to healthcare can be seen in many ways. Organizations have shuffled clinicians and physicians into new roles to help manage COVID-19 patients. Specialists with elective surgeries on hold are being called into emergency and intensive care. Out-of-network clinicians are crossing state borders to provide help to areas that have been hit the hardest.
These are just a few of the ways that healthcare is changing, and with each comes with an onslaught of administrative challenges, including onboarding tasks between payers and providers. Traditionally, clinicians practicing in a new network have to onboard with payers through a process called payer enrollment. While providers do their credentialing, payers do their own as well. This process normally takes weeks or months to complete.
Needless to say, people do not have extra time to spend on new paperwork. On top of that, teams that traditionally handled payer onboarding and other billing-related tasks may be short-staffed, inundated with other tasks, or less efficient due to remote working challenges.
Payment challenges are rising, too. Before coronavirus, 30% of claims payments were still being completed manually via phone, email, or fax. These methods, compared with fully electronic payments, are often slow, cumbersome, and error-prone. After receiving a physical check, providers must let it pass through new protocols for COVID-19 safety, and then worry about depositing the funds.
Electronic payment is critical as providers face declining revenue and more acute care needs, which are among the most expensive services in healthcare. And as the providers and payers that have lagged in e-payments start to sign up, there are more administrative tasks to complete.
Recognizing all of these challenges, payers across the nation have loosened the usually bureaucratic restrictions on the business of healthcare to ensure that clinicians can give patients the care they need without worrying about if and how they’ll get approvals and payments.
Medicare led the way with the 1135 waivers at the end of March by suspending some prior authorizations and removing red tape around referrals and out-of-network practice. And payers across the nation have responded with many new telehealth allowances, faster electronic funds transfer (EFT) processes, and lightened pre-service work.
But, keeping up with these changes and the specific guidelines to take advantage of them is another administrative hurdle for providers to jump.
Fortunately, intermediary organizations have stepped up to fill in the gaps. Availity, one of the many organizations helping payers and providers work together better, has developed a COVID-19 Provider Resource Center to consolidate and organize the many COVID-19 updates from payers for any provider to easily access. On average, providers do business with 25 payers. So, resources like Availity’s resource center will help providers not have to shuffle through paperwork, email attachments, and various portals to find payer information that is changing almost daily.
A silver lining is that COVID-19 is exposing the unnecessary challenges and steps in many of healthcare’s administrative processes. And, as the industry adapts with more digital integration and less manual labor to make this administration easier, our hope is that it sticks.
