The COVID-19 pandemic, a global nightmare that has hit the U.S. especially had grim statistics that speak volumes are indicative of, so to do the life-threatening challenges that overburdened healthcare organizations are now facing as the COVID-19 runs its course. Hospitals are packed beyond capacity with patients now needing to be treated at emergency makeshift facilities. And while Providers on the front line deal with life-threatening situations, this crisis will no doubt impact how Provider and Payer organizations must react to all the more critical demands to credential Providers and enroll them into health plans.
Although working to ensure that the care and treatment of victims of this pandemic is now paramount, ensuring that Providers and Provider organizations get timely and accurate reimbursements must also be addressed. The bulk of the burden of these administrative challenges will almost certainly fall on the shoulders of Payers’ and Providers’ administrative operations.
With many medical professionals now working 24x7, emergency patient admissions are increasing at unsustainable rates that are causing severe shortages of Provider staff while also jeopardizing the safety of our healthcare professionals. There is now an exploding demand for additional Providers that are and will be sorely needed to fight this and future recurrences of this type of crisis. A spotlight will therefore almost certainly be placed on ensuring an organization’s ability to onboard, credential and enroll Payers into plans is up to the task. Payers will also be facing similar challenges, which will include the ability to quickly build and maintain quality networks. Unfortunately for many Provider and Payer organizations, there is a reliance on infrastructures and business processes that are outdated, difficult to scale and already posing operational challenges that this pandemic will only further worsen.
These are unprecedented times for Provider and Payer organizations, which will require more efficient and timely enrollment, privileging, credentialing and network management capabilities. This Pandemic will almost certainly be a driver that will require organizations to modernize their systems and business processes to better ensure readiness in the event of future similar crises.
Fortunately, in the short term, CMS has made several announcements regarding the lifting and loosening of various regulations to allow Provider and Payer organizations to better deal with these unprecedented times. Examples of COVID related guidance include temporary leniency for compliance regulations and facilitating timely if not immediate reimbursement of funds to Providers and Provider organizations, providing out of state license to Providers, and postponing practically all steps that slow down critical processes. Payers and Providers should therefore start to proactively enhance, streamline and strengthen Provider management capabilities wherever possible.
Santech Is Ready To Assist
Santech stands at the ready to assist customers and prospects determine how best to face these unprecedented challenges. By appropriately leveraging technology, resources, and subject matter expertise to minimize, automate or eliminate inefficient processes while also streamlining enrollment, privileging, and credentialing capabilities.
Santech remains committed to continue working with healthcare organizations at their pace and convenience as it understands what they’re going through.
