by Rose Dunn, MBA, RHIA, CPA, FACHE, FHFMA
In addition to the terrible human cost of the COVID-19 virus and the general impact it is having on the healthcare industry, there are two ways in which the pandemic may affect your HCCs.
- With people being told to stay home, the reduced number of visits to providers means there is a good chance that your per member per month (PMPM) reimbursement may drop if your practice or ACO is being reimbursed via HCCs.
- Unfortunately, given the risk that the elderly have with coronavirus, your patient population may be less in number, especially if you are located in an area where there has been a high death rate.
How can your practice stem the impact? Telehealth may provide one answer.
Under the CARES Act, telehealth visit options have been expanded and allow you to check your patients’ current conditions and update their health risk assessments (HRA) for the annual wellness visit or any other visit type. Telehealth visits can occur virtually anywhere so you can reach out to your patients if they are seasonal birds and live in different regions of the country or world during different times of the year. (Note that your practitioner needs to be licensed in those states for that service.) Recognize that some of your patients may not be able to manipulate the technology necessary for a successful telehealth visit.
If you are working in the office and have access to the patient’s records, prepare for the visit by creating a log of all the conditions that the patient has had in the last 2 years or more. Finally, make sure your claim system editor and clearinghouse have been updated to accept the new codes. Prioritize those patients you have not seen since January.
There are codes available to code the visit as audio only vs. audio and visual. New and established patients may participate in telehealth visits.
Good luck and stay well!
HCC: Fundamentals of Hierarchical Condition Categories
Prepare for the future of healthcare reimbursement with HCC: Fundamentals of Hierarchical Condition Categories, by nationally recognized HCC authority Rose T. Dunn, MBA, RHIA, CPA, FACHE. Learn more here.