(As featured on Xifin website)
By John (JD) Donnelly, CEO, FrontRunnerHC
For many years, labs - both independent labs and within hospitals – have worked behind the scenes, quietly playing a critical role in the patient care journey. In fact, the lab is often one of the first crucial steps in that journey, providing information to help keep us, or potentially get us, healthy.
In many ways, the COVID-19 pandemic has thrust labs from behind the scenes to their rightful place of importance in the forefront. It’s become common now to see labs when you turn on the TV or when you scroll through the news online. Labs come up in conversations as people talk about the testing being done. Many of these labs who have always done crucial work to advance the care of one patient or a group of patients are now also working on behalf of our country. They are doing their best to keep up with the continued need to process COVID tests as a foundational step to flatten the curve.
Just as I am grateful for all healthcare workers, I am also grateful to these essential workers in the labs who have been doing heroic work every day for more months than any of us would like. They are working tirelessly to keep up with the long lines and packed waiting rooms. And while many work to conduct the volume of COVID tests needed, their colleagues in the revenue cycle and billing department are also working to keep up with the volume. Each COVID test done must be processed, and a bill generated. Ask anyone doing this job and they’ll tell you that it’s easier said than done.
The appropriate recipient of the bill may be an insurance company or the U.S. Health Resources & Services Administration (HRSA) which provides funds for COVID-related testing and treatment for the uninsured through the CARES Act. The reimbursement claims process and government guidelines to comply with the CARES Act can be very time consuming and can overburden teams who are trying to keep up with the testing volume. This, added to the everyday complexities of the insurance industry, means there are more opportunities for error. The revenue cycle and billing staff are working hard to find the right patient information (a task likely made more challenging if some of the information has been entered by a technician wearing a mask and gloves in a drive-through testing site) or to navigate the HRSA website and gather the needed information, to name just a couple steps in the process.
So, is it really a big deal if the COVID test isn’t processed fast or accurately? Yes, it really is. It slows the whole system down – and it’s a system we can’t afford to slow down. A bottleneck in the workflow has implications for the healthcare facilities and for all who are trying to get their COVID tests done… and because of that, it has implications for our country.
It takes accurate patient demographic and insurance information to process each COVID test. Without it, the COVID test gets delayed, staff must waste their precious time trying to track down the right information, and the queue of people both waiting for tests to be done and waiting for test results can get longer. And without accurate patient information, the bill can go to the wrong place – one reason patients may receive a surprise bill that perhaps should have gone to HRSA. And on a broader scale, without appropriate compensation – from either the insurance companies, HRSA, the patient, or a combination of these – the labs’ continued ability to offer COVID tests and other critically-needed services can be threatened.
This is why we developed COVID-Assist. Offered with a cost-sharing model, our software solution is helping hospital and independent labs accelerate and automate COVID test reimbursements, reduce the struggles involved with processing claims, and remain compliant with the CARES Act. It automates the process of gathering the patient data, verifying insurance coverage of a patient’s self-pay status, and capturing the necessary HRSA Member IDs. COVID-Assist then provides uploads that are fully audited and compliant patient files to our clients’ billing systems to submit to HRSA or insurance carriers. Organizations can scale up to 100,000 tests a day without impacting their staffing levels as it relates to patient information.
Realizing labs may be in unchartered territory as they seek to efficiently process all the COVID tests while ensuring compliance with the CARES Act, we have held virtual User Group Forums for our COVID-Assist clients. Our intent is to share our knowledge, and to promote an exchange of non-confidential best practices and experiences between the labs as well. In these forums, labs, that may at other times compete. shared their experiences to help one another and help the country. And some of the discussion during these Forums prompted additional enhancements to COVID-Assist as we saw more opportunities to make their jobs easier.
The creation of COVID-Assist was spurred by our desire to help healthcare facilities and labs who are stepping up during the pandemic in whatever way we could. The solution is now being used by many labs across the country who are processing COVID tests. We were honored to hear a client at a leading national COVID testing lab say that “FrontRunnerHC is the only reason we've been able to do what we do, on the level that we do it.” We are helping clients process over a million COVID tests per month, and our software can do much, much more.
If you work in a lab or healthcare facility who is doing COVID testing, thank you! On behalf of all of us at FrontRunnerHC, we are truly grateful. And we’d be honored to help you too. To learn more about COVID-Assist, check out https://www.frontrunnerhc.com/covid-19-lp or reach out to me at firstname.lastname@example.org.
(Also featured on Xifin website)