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Effectively handling clinical denials amid a pandemic backlog of elective surgeries


Lisa Dadulo, Clinical Practice Director, HGS Healthcare, shares how technology can help effectively handle clinical denials amid the backlog of elective surgeries during pandemic.

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Article originally published on HIT Consultant
Written by Lisa Dadulo

Throughout the pandemic, many hospitals had to delay elective procedures for several months or cancel them altogether.  Surgical volumes decreased over 35% in 2020 from March to July.  This has led to a projected backlog of elective procedures and surgeries.  For example, in orthopedic surgeries such as joint replacement and back fusion, it was estimated the pandemic would generate a backlog of over one million surgical cases.  If you multiply that across all the surgical specialties and then add on the other elective testing procedures such as imaging or outpatient testing, there is a cumulative effect of delayed healthcare for patients and a high backlog of case volume for healthcare providers.  Physicians, healthcare facilities, and providers are currently working their way through this backlog of delayed care as the pandemic is shaped by the roll-out of COVID-19 vaccines and updated COVID-19 guidelines.

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