As COVID-19 stretches into the fall, we continue to see the effects of the pandemic on public and private benefit programs. With more changes than ever, including changes to eligibility, the introduction of new programs, and Medicaid expansions, an increasing number of patients are eligible for coverage.
Three states are expanding Medicaid in the next year, affecting over half a million Americans. This change will allow for more people to meet Medicaid criteria, particularly low income childless adults. With more patients than ever before, qualifying patients quickly and accurately is key to converting self-pay to covered visits.
Insurance programs and benefits are constantly shifting eligibility requirements, application processes, web site navigation, and more. In Q1 of 2020, we saw 2,366 changes to programs, a record high compared to the last several years of data. This means that for a frontline team member screening patients for coverage, it is next to impossible to keep up with the latest requirements. Misinformation is harmful to the patient and the healthcare facility, leading to denials and preventing reimbursement for services rendered.
In the time of COVID-19 this is more true than ever, with changes being made to presumptive eligibility and other program features aimed at addressing the growing healthcare and unemployment crisis. Here are some of the most important changes we tracked in the second quarter of 2020:
Due to the COVID-19 pandemic, resulting job loss and healthcare crisis, coverage has never been more important to patients and the facilities that see them. Coincidence with these current events, PointCare has tracked the highest number of changes to Public, Private, State, and Federal level programs in the last two years. In the first quarter of 2020 there were 2,366 updates, including changes to applications, websites, contact information and more.
PointCare makes it easy to manage self-pay patient enrollment, even in these chaotic times. When you convert self-pay patients you have more covered visits resulting in additional revenue. This can only happen if enrollment teams have current information on programs and eligibility. Here are some of the most important updates to share with your enrollment team: