As COVID-19 continues to reverberate across industries, healthcare has been all but immune.

For substance abuse and recovery practitioners, COVID-19 presents massive operational hurdles. Your visits have likely plummeted, and you’re almost certainly dealing with reduced patient loads, shrinking margins, and immense fiscal pressure. In the wake of this pandemic, it’s critical your substance abuse and recovery programs continue to operate optimally. Not only is COVID-19 creating new mental health challenges (e.g., depression, anxiety, etc.), but it’s hitting those with substance abuse issues especially hard. People struggling are holed up in their homes as local, state, and national guidelines suggest social distancing and shelter-in-place rules continue to apply in certain states. This leaves them vulnerable to relapse and increased mental health issues.

While you want to create a holistic, patient-centric strategy to deal with COVID-19 and its aftermath, you should also be focused on your business operations to ensure you can continue to keep serving your patients. Today, let’s look at how revenue cycle management automation can help substance use and recovery practitioners and their facilities mitigate some of the economic fallout surrounding the novel coronavirus pandemic.

Behavioral Health Centers are Hurting

Despite rallying calls from media outlets and the American Psychological Association that mental health and substance abuse facilities are critical during the COVID-19 pandemic, a majority of practitioners are under immense financial pressure. Outpatient visits at behavioral health centers are down 60%.

In other words, at a time when people need you most, you’re at your most vulnerable. The perfect storm of unemployment, social distancing, and stay-at-home orders have the very real (and highly documented) potential to surge substance abuse problems. Many patients are struggling. But for those of you with boots-on-the-ground, remaining financially solvent against changes in billable frameworks and care delivery is equally challenging.

For hospitals dealing with surges of COVID-19 patients, many of the losses stemming from this pandemic may be somewhat offset, but for behavioral health agencies, who don’t directly treat this group of patients, inpatient and outpatient numbers are shrinking — with many treatment centers closing down temporarily during the pandemic. While some practitioners may work in facilities that have the financial health and framework to survive this pandemic, many others are in desperate need of liquidity. This may come in the form of government funding at the end of the pandemic, but that agreement hasn’t been set-in-stone.

For now, we’re all dealing with the financial uncertainty this pandemic brings. Unfortunately, it’s not just practitioners and treatment centers that are in a tight spot — so are patients.

The Role of Revenue Cycle Automation

Creating patient-centric practices revolving around compassionate care  is ideal, but can only  occur when the financial wheels are turning. Revenue cycle management is how facilities identify, manage, and collect payment from patients across administrative and clinical pipelines. Unfortunately, the traditional revenue cycle is plagued with time-consuming manual processes that require micro and macro oversight.

Combating shrinking margins and financial pressures requires a complete reboot of existing revenue cycle strategies (or lack thereof). Manual and cumbersome processes that clog up your revenue cycle can create significant cash flow strains for systems already under financial pressure.

From reconciling claim denials and minimizing write-offs, to maximizing intake efficacy, automating your revenue cycle pipeline helps reduce claims denials and improve overall billing. Customizing and maximizing revenue workflows brings tangible value to your bottom line. And automating that workflow gives you the breathing room to eliminate redundancies and human error while freeing up your clinicians and staff to focus on more critical tasks.

Again, this is especially important during the COVID-19 crisis, as furloughs become commonplace. Having the option to add automation may keep your facility from buckling under economic pressure. Of course, revenue cycle automation can’t completely save your practice from the current economic climate, but it can help you get the most out of every transaction— from intake to claim submission.

When we look at the COVID-19 financial landscape, we see two major pain points:

1. Facilities have fewer patients, so they need to make sure that all of their legitimate charges are compiled on claims and that no claims are denied
2. Billable services need to be expedited to access critical liquidity

How Revenue Cycle Management Can Help You Alleviate Claims Concerns

Claims have been a longstanding thorn in the side of the healthcare billing process. A mere 10% of claims are filed electronically, and overpayments and underpayments from insurers can create near-constant headaches for billing specialists who are trying to balance the books and comply with regulatory oversight.

In the COVID-19 landscape (and during the post-crisis bounce-back), facilities may be dealing with either an influx of patients or a reduction of patients (depending on the period of the crisis). In these flux periods, being able to accurately manage billing is critical. Every missed legitimate charge and every rejected claim is a pain point that creates extra friction in your workflows.

72% of hospital CFOs consider RCM to be a critical component of their overall billing needs for a reason; managing claims and charges keeps the wheels turning. In traditional recovery center billing practices, all of these claims and charges are handled manually. But, when you consider that the “best-case-scenario” benchmark for manual input is a 1% error rate, the pure scale of missed charges and denied claims is significant. Imagine investing in staff, processes, and frameworks only to miss charges on a patient (or more) per day.

When we add the ever-evolving nature of COVID-19 to the scenario, these missed charges can contribute to liquidity issues. RCM turns this upside down. Since your entire billing workflow is automated, you create a more holistic patient-to-payment solution that reduces claims denials, streamlines collections, and ensure that patients are charged accurately. By onboarding the right RCM solution, you can avoid the hodgepodge of missed cash flow, denied claims, and angry patients that will inevitably come out of the post-crisis mental health scenario.

How Revenue Cycle Management Can Maximize Your Value-per-Patient

There’s more to revenue cycle management than simply maximizing claims and charges. Deep layers of reporting, best-in-class security features, HIPAA compliance, and a swarm of other features typically accompany best-in-class Revenue Cycle Management Automation solutions.

There are plenty of ways that revenue cycle management automation can improve your operations during COVID-19 — all of which can create financial solvency now and in the future.

• RCM helps reduce staff burdens during overwhelming shifts. This happens in two layers. For starters, you reduce friction with dedicated billing staff (if you have them) by automating the more repetitive components of their jobs and offering workflow tools to help them understand the entire revenue ecosystem — from intake to claims. Second, RCM reduces physician and substance abuse specialist burnout. 44% of physicians, regardless of specialty, experience burnout, and a contributor to that burnout is administrative duties, which around 25% of recovery practitioners spend up to 10 hours a week dealing with. By automating your revenue ecosystem, you give practitioners back their hours and reduce your overall in-house staffing burden. Better yet, an efficient RCM solution also provides scheduling and workflow tools to help practitioners with their daily clinical practices.
• Automation can sweep for coverage information for Telehealth services. This is increasingly important in an era where Telehealth is becoming an increasingly viable solution for patients during a pandemic.
• RCM can find coverage information and payer mix during this complicated period where plans and coverages are shifting radically. Given the large number of new codes and shifting plans (over 9 million Americans have lost coverage during the pandemic), revenue cycle automation can help reduce the complexities introduced by this pandemic by automatically matching and discovering coverage.
• RCM helps you automate and simplify reporting. In fact, 11% of RCM users point to clearinghouse reporting as the most significant benefit they’ve received from the solution. Reporting isn’t just critical for budgeting and oversight; it keeps you compliant which reduces regulatory headaches.

In a nutshell, revenue cycle automation helps you improve your overall claims and billing workflows. In addition, it provides significant relief for staff, who may be struggling to keep up due to furloughs. For struggling treatment centers, maximizing revenue for each patient could be the difference between financial health and financial strife.

Keeping Your Lights on and Your Patients Healthy

The COVID-19 pandemic has created unprecedented financial strain for most substance use & recovery practitioners and their respective facilities. At a point when your patients need you most, you may be facing a brick-wall of bills and debts. This pandemic will end— but it shouldn’t take your financial health with it. At Procentive, our clinical EHR and billing services have helped thousands of mental and behavioral health as well as substance abuse providers across the country thrive. From automated revenue cycle management solutions to workflow engines and clinical workflows, we can help your facility combat the growing economic pressures of today and tomorrow.

Contact us to learn more about how our solutions can help you deliver superior clinical results with more profound financial outcomes. You have patients that need you. We’ll help you put aside the financial and technical restraints introduced by this pandemic so you can focus on what really matters — your patients.