Coronavirus and the Healthcare Call Center


LVM Systems

By Mark Dwyer

Healthcare call centers face unprecedented challenges in response to the Coronavirus (COVID-19) pandemic. At a time when efficient call processing is even more critical than usual, due to increased call volumes, call times have lengthened. Much is attributable to the plethora of misinformation individuals have readily available to them over the internet, via the media, and from family and friends. Now, not only do call center nurses need to calm the caller, they must correct the caller’s misunderstandings.

Add to this the pace at which medically valid updates occur. Triage call centers must keep up with the weekly, and sometimes daily, changes to the guidelines for handling possible COVID-19 calls.

COVID-19 has generated tremendous activity related to telehealth as a method of triaging and treating those who are infected. Given that COVID-19 symptoms can vary from very mild to severe and that the virus spreads through close contact, telehealth can be a powerful tool in combating the crisis.

Health center providers may now deliver in-scope services via telehealth to individuals who have not previously presented for care at a health center site and who are not current patients of the health center for the duration of this public health emergency. These include triage services with or without initial consultations. Some of the specific changes include:

  • Continuation of zero member liability (such as copays and cost-sharing) for care that is delivered via telehealth.
  • Any services provided virtually will be eligible for telehealth coverage.
  • All prior authorization requirements for telehealth services will be lifted for dates of service from March 17, 2020, through June 30, 2020.
  • Telehealth services may be delivered by providers with any connection technology to ensure patient access to care.
COVID-19 has forced healthcare to look at all aspects of its care delivery system. Click To Tweet

New Telehealth Policies Expand Coverage for Healthcare Services

Numerous states have taken steps to waive their requirement that a physician is licensed in the state to provide care to patients through their declarations of statewide emergency. More states are sure to follow.

According to Gregory A. Hood, MD, an internist in Lexington, Kentucky, who is on the advisory board of Medscape Business of Medicine, “The waiving of state licensure requirements should help ease a number of stress points of the current crisis in ways that benefit society.”

Healthcare providers, supported by states and payers, can leverage telehealth in ways not possible in previous epidemics to triage, diagnose, and treat patients while effectively protecting healthcare workers and reducing the spread of the disease. States that have broad authority as payers can play a crucial role in driving the use of telehealth as a method of treatment by implementing reimbursement policies that enable providers to offer virtual care services to patients.

Like many other aspects of the United States’ healthcare industry, when COVID-19 ends, the healthcare call center will never be the same. We will work smarter, more efficiently, schedule more creatively, and support more remote staff. We will embrace telehealth, tele-triage, and telemedicine with video calls, chat, and online physician consults.

More insurance companies will reimburse for online physician visits enticing more to participate. Triage call centers may also have more opportunities to work with EMS and police stations to help triage patients. Finally, data sharing will increase to the patient’s PCP into their EMR records or other approved endpoints. Data aggregation and reporting will enable call centers to analyze better yearly trends leading to heightened prediction and prevention of disease. 

COVID-19 has forced healthcare to look at all aspects of its care delivery system. May we all be the better for it. 

LVM Systems logo

Mark Dwyer is a veteran of the healthcare call center industry and serves as COO of LVM Systems.