As the medical community battles the growing COVID-19 outbreak, Bill Dog has been preparing to respond to the surge of billing and claims issues that are coming to employees.
As of March 24, 2020, here are three things health insurance brokers should expect:
Flood of rejections due to ramp up in testing
As the COVID-19 testing ramps, each may be handled differently depending on the situation. If administered by the CDC, testing will be free. In other instances, insurance companies could waive the copays. Most carriers will begin to process claims on April 1 with dates of service on or after Feb. 4, however, claims submitted before April 1 may be rejected.
Jump in surprise medical bills / Out of Network Claims
It has been reported that 1 in 5 COVID-19 patients will require hospitalization. The overflow will drive providers and hospitals to break standard protocol. Expect out-of-network charges to jump as non participating providers step in to assist in the response. Providers who are inactive have been given the ok to practice. Inactive providers have no network. Current providers have been ‘okayed’ to practice across state lines. Also expect non-acute patients to be evacuated to rehabilitation centers or nursing homes without regard to network status. The rise in ER visits and ambulance costs will also bear down on employees.
Increase in billing error due to rapid development of new diagnosis codes
New diagnosis and procedure codes are currently being created by the CMS and AMA to handle the symptoms and treatment of COVID-19. As providers struggle to keep up with patient volume and triage non acute patients, we expect the administrative systems will be overloaded and coding errors will increase. Technology teams at insurance companies and providers will modify their systems and update their databases on their own time which could further the disruption.
Bill Dog is prepared to help. Contact us for a one-on-one consultation.