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The spread of COVID-19 has gripped the world. Beyond the medical response to this crisis, the markets, political and business worlds have responded with panic.
Fear is expected in a pandemic. But fear limits us from taking the right action. It’s time to take stock of the situation and lead.
There’s plenty of information on clinical and human impact of the crisis. I’m going to mainly consider the business impact of coronavirus on GI practices. And curate certain resources and articles for you below.
There are two economic scenarios:
1/ Coronavirus subsides. This will cause temporary disruption. Many will reschedule elective procedures (e.g. preventative colonoscopies). A certain percentage of the seniors will avoid elective GI procedures altogether. Some GI practices have closed offices for the rest of March. This scenario could result in a three month drop in patient volume by 20-25%. We can also assume a related revenue drop of say 10-15% during the same period. Normal activity will resume by May/June. This scenario could result in lower practice reimbursements in 2020 – even if normalcy resumes in Q3.
2/ Coronavirus continues. This will cause sustained disruption. US (and world economy) will enter “full-fledged” recession. In this scenario, GI practices are likely to have ongoing reduced reimbursements by say 5%-10%. It could also result in decline in profitability if fixed costs remain the same. CMS is unlikely to increase reimbursements for GI procedures. According to PwC, the 2008 recession created a “new normal” on healthcare spending. While hospitals slowed down, ASCs and physicians offices improved in the last decade because of their lower costs for outpatient care. That’s possible depending on regional hospital vs ASC dynamics. Economic experts are predicting a likely recession regardless of the duration.
What must you do?
These are a few near-term recommendations to manage business impact of the crisis.
1/ Managing expenses. Ensure you have three months operating expenses. Apply for a larger line of credit if needed. Assess impact and decide what expenses are you going to curtail.
2/ Billing and reimbursements. Bring operational focus to higher-dollar claims. Bring extreme focus to infusions, video capsule endoscopies, ERCPs and other expensive procedures. This means ensuring that the front-desk is focused on capturing accurate documentation, coding and billing these claims at a rapid pace with high quality, AR follow-up with insurances multiple times after 20-25 days from date of service.
3/ Create back-up billing staff. If you are depending on few individuals for billing, it’s time create backup resources – either temporary hires or outsourced ones.
4/ Risk assessments. Consider risks such as a situation where a key doctor becomes unavailable, what impact would that have. What can you do to increase utilization of fixed resources?
5/ Business continuity. This requires you to categorize staff roles into possibilities of remote and not-remote. Test working-from-home for staff. This might entail having them securely VPN into your office network.
6/ Telehealth. Switch possible consultations into Telehealth consultations. This week, physicians are even using Zoom and WhatsApp video calls. See below for article on latest CMS mandates regarding Telehealth.
7/ Patient Communications. Review your schedule for the next 30-60 days. Filter out patients based on what procedures are possible to delay and what are not (resources below). Identify via your website and email communications on your practice hygiene practices. Demonstrate your readiness during patient visits.
In a later note, I will follow-up with longer term recommendations (like moving towards digital GI in a post-Coronavirus world). Meanwhile, this study talks about low rates of hand washing amongst GIs. Stay safe.
Comment below and share what steps your practice and endo center is taking. Let’s add it to this list and share a resource page.
If you need assistance in IT/network setup for remote access, billing/coding/AR support, comment below. I’ll connect you with the right teams.
Here are a few resources for GI practices.
This shareable presentation on COVID-19 recommendations for GI practices was created from Joint GI Society Message.
Pertinent articles:
Early GI symptoms in COVID-19 may indicate fecal transmission (Medscape)
Coronavirus (COVID-19): new telehealth rules and procedure codes for testing (AAFP’s Getting Paid blog)
6 Coronavirus (COVID-19) considerations for telehealth providers (HIT Consultant on upcoming changes on Telehealth policies and payments)
8 Questions employers should ask about Coronavirus (Harvard Business School’s blog for employers)
Some patients delaying procedures amid coronavirus outbreak. Analysts predict what it means for hospitals (Fierce Health)
Anticipating coronavirus impacts on private practice: A thought experiment (Healio)
CDC Resources:
COVID-19: Frequently Asked Questions (Immunologist recommended resource for patient education)
Interim infection prevention and control recommendations for patients with suspected or confirmed Coronavirus disease 2019 (COVID-19) in healthcare settings
Interim guidance for businesses and employers
CMS Telehealth Services Resources:
Coverage and Payment Related to COVID-19 Medicare
Telehealth Services
You may also be interested in:
COVID-19: Telehealth rules + billing/coding guide


By Praveen Suthrum, President & Co-Founder, NextServices. 

$2T CARES Act: What do GI practices need to know right now?

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