Updated: Mar 19, 2020
There has been a lot of information released regarding the treatment and prevention of the COVID-19 pandemic. Hospitals and physician practices have been implementing strict infection control policies and many employers are having their employees work remotely from home. Healthcare workers are working extremely hard to treat and test patients for COVID-19 and standup screenings are starting to appear all over San Antonio. Slowly, but surely we, as a healthcare community, are making strides to screen, treat and care for patients with COVID-19. While this has been a huge effort that is still ongoing, we are starting to feel the pressures on the business side of healthcare. So what is being done?
Many insurance companies are waiving copays and cost sharing for patients. Medicare was one of the first to do so, but be careful to ensure what is being waived. For example, many insurers are waiving the copays on COVID-19 testing. That means that if a patient comes into the office and is only screened, not tested, the copay will still apply to the visit. It is important to keep up with the latest on each plans.
The other update that was recently released is the creation of a CPT code to cover Coronavirus testing. The CPT code is 87635 (Infectious agent detection by nucleic acid (DNA or RNA); severe respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique. This code became effective on 3/13/20. If you are in a facility that is providing testing, be sure to have this code updated in your system to allow for timely and appropriate billing.
Lastly, in an attempt to keep patients from coming in contact with one another, many insurances are expanding telehealth services. Medicare is the first to expand telehealth services to combat the COVID-19 pandemic. Medicare will be reimbursing telehealth visits and temporarily relaxing some of the HIPAA requirements. This means that physicians will be able to provide telemedicine services over interfaces including Skype and FaceTime. The federal government has been requesting that state Medicaid offices do the same, but that has not been officially released yet. Other insurances are following closely behind, with Aetna sending out notices to providers this morning, expanding telehealth services and eliminating some costs for patients.
The other large thing that remains to be seen is how the government will provide additional funding, whether through the Small Business Administration or other resources, for offices that are required to close. Many practices, especially in the San Antonio and surrounding areas, are small businesses and closure or reduction in services can have a critical impact on the health of the business. With rumors of elective surgeries being cancelled, it is very important to have a number of backup plans ready to go to ensure patients are still being cared for, employees are still able to be paid, and business are able to maintain some sort of bottom line after paying fixed costs.
We at Nolan Health Care Solutions will be constantly updating on our social media and blogs so that you can stay abreast of the latest. We are also offering free 30 minutes phone consultations for you to ask questions about how to plan for the virus in your office. These can be booked directly on our website.