Further, at a time when some staff members are likely working remotely, it makes sense to optimize the submission of electronic transactions while minimizing the use of paper. Many types of transactions can be sent and received electronically, including eligibility, drop-to-paper primary, drop-to-paper secondary, workers’ compensation claims and automobile liability claims.

Review and optimize operational processes: Today’s lull in business presents an opportunity to review common operational processes and focus on improvement. For example, examine average days in accounts receivable, which should generally hover around 30 to 40. In terms of outstanding claims to prioritize, look initially at payers that generally pay promptly, as well as oldest date-of-service and high-dollar amounts.


Provider offices should take this time to review denial trends and determine what can be addressed in the upfront billing process moving forward. Reviewing denials by payer, service type, and reason codes can help providers identify problem areas and bottlenecks. This is an opportunity to update existing workflows and/or utilize practice management systems or clearinghouses to implement edits to prevent denials in the future.

Additionally, review current policies and procedures with an eye toward opportunities to enhance efficiency and productivity. For example, practices that do not collect payments or check eligibility up-front may consider using some of the current downtime to investigate the feasibility of implementing these advancements that could drive better financial performance and more efficient operations.

Take advantage of the help that’s out there: Some providers recently received a reprieve when the deadline to file for Medicare’s Merit-based Incentive Payment System (MIPS) program was extended by 30 days due to the pandemic. While MIPS-eligible clinicians submitted the appropriate 2019 quality data to the federal government on April 30, a recent policy change associated with “extreme and uncontrollable circumstances” means that individual physicians will not be scored on performance categories for which quality data was not submitted.

Separately, the recently passed Coronavirus Aid, Relief and Economic Security (CARES) Act includes a number of provisions intended to help providers overcome the business slowdown associated with the virus. For example, the legislation includes $100 billion to help providers cover the costs of treating COVID-19 patients, in addition to easing the financial burden on practices that lose revenue due to reduced demand during the pandemic. Additionally, physician practices with fewer than 500 employees may qualify for loans of up to $10 million to help cover payroll and overhead costs from the Small Business Administration.

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