Created by the Texas Medical Association. Read their article about it here.
By now, you have most likely made several practice changes to keep you, your staff, and your patients safe during the COVID-19 pandemic, including requiring face masks, keeping sick and well patients separated, and using telemedicine wherever possible.
But patients coming to your practice – for COVID-19 care or other health issues – might not be aware of all you’ve done.
The Texas Medical Association is here to help.
TMA has created a digital poster you can share with patients before they arrive that outlines your COVID-19 safety precautions. The poster includes steps for patients, such as calling ahead to learn your practice’s facemask policy, completing intake forms before arriving, and asking family members to stay home. You can send it to patients before their appointments, post it on your website, and share it on your social media accounts.
The “COVID-19 Safety at the Doctor’s Office Checklist” also outlines some of the steps you might’ve taken, including checking patients’ temperature in their vehicle, and social distancing in the waiting room. Also, TMA soon will publish a version for you to download, print, and post in your office.
If you’re looking for more tips and resources to increase patient visits safely, TMA’s practice viability experts have organized the information you in need in one document: Road to Practice Recovery: A Guide for Reopening Your Practice Post-COVID-19.
The COVID-19 pandemic led to a public health emergency the damaged medical practice viability. Physicians are in the difficult position of having to navigate operational, financial, and clinical challenges while still staying up-to-date with compliance, payment, and coverage issues. These changes have had a significantly negative impact. According to TMA’s COVID-19 telephone town hall meeting in mid-April, 36 percent of poll respondents indicated that they have lost between half and three quarters of their revenue since the start of the pandemic. Another 24 percent have lost three-quarters to all of their revenue.
As the COVID-19 curve flattens and trends downward, you can take decisive actions to restore your practice operations. TMA’s practice viability experts have organized the information you may need to successfully reopen your practice in one resource: Road to Practice Recovery: A Guide for Reopening Your Practice Post-COVID-19. From evaluating staffing levels and managing patient appointments, to ensuring patient safety and communicating regularly with patients and staff, this guide will provide the information practices need to more confidently head in the right direction.
Refer to TMA’s COVID-19 Practice Viability web page for additional tools, resources, and frequently asked questions regarding operational challenges that affect your practice’s viability.
In December 2019, the world learned of a new Coronavirus called SARS-COV-2, causing the disease COVID-19 in which patients were experiencing respiratory illness and death in Wuhan City, Hubei Province, China.
Since then, we have been deluged with information about the virus, its epidemiology and transmission, its target populations, and its effects on new human hosts. COVID-19 has captured the attention of most of the world.
We have learned much in the last few months. The viral genome has been sequenced, permitting development of diagnostic tests and paving the way for development of vaccines and antiviral therapies. Several excellent sources of curated scientific data regarding COVID-19 became indispensable in our understanding of the rapidly changing guidance regarding how best to respond to challenges posed by the new virus.
These sources include the Johns Hopkins COVID-19 website, which updates worldwide data on cases and deaths in real time; the World Health Organization (WHO) COVID-19 website, which updates daily and has been prolific in issuing and amending guidance on measures designed to blunt the impact of COVID-19 worldwide; and the Centers for Disease Control (CDC) COVID-19 website, which was for several weeks the only outlet for testing in the U.S., and whose guidance is crafted with U.S. healthcare workers, other affected workers, and the broader public in mind.
As of April 27, 2020, per the Johns Hopkins COVID-19 site, there were more than 3,000,000 confirmed cases globally, and 208,131 COVID-19 deaths worldwide, with more than 993,103 confirmed U.S. COVID-19 cases and 55,729 COVID-19 U.S. deaths. For reference, on March 25, 2020, Johns Hopkins reported 54,000 U.S. COVID-19 cases and 787 U.S. COVID-19 deaths.
With no proven effective treatments or vaccines yet available to curb COVID-19’s worldwide impact, controlling the virus remains focused on time-tested communicable disease control measures. These include social distancing, hand hygiene, respiratory etiquette, staying home if ill, cancellation of mass gatherings, school closures, and the shuttering of nonessential services and retail establishments.
Against this background, healthcare providers and patients struggle to keep up with voluminous and changing guidance and filter out the cacophony of misinformation which has dominated some corners of the internet and other outlets.
Testing has been difficult in many places, including the U.S., due to a shortage of test kits (swabs and viral transport media) and reagents required for testing. In the U.S., only the CDC’s Atlanta laboratory could test initially, and results could take several business days. Eventually state labs were authorized to test and the Tarrant County Public Health North Texas Regional Laboratory (a Laboratory Response Network facility) began conducting tests using a two-target real-time polymerase chain reaction assay developed at the CDC. Commercial laboratories are now online with testing as well, facilitated by FDA emergency use authorizations to address scarcity of testing capacity.
With schools and many businesses closed, our lives have been altered, and we all know people stressed by the measures implemented to curb the spread of COVID-19 in Tarrant County. Frustration and fear of COVID-19 have been felt throughout our country and across the world.
We have also watched the devastating effects of COVID-19 on populations and healthcare infrastructure in Washington, California, New York, and elsewhere. Tarrant County Public Health and its partners are assisting with the COVID-19 response, investigating cases and contacts, in hospitals, long-term care facilities, correctional institutions, and other settings. (COVID-19 is especially threatening to the elderly, and persons with diabetes, heart disease, underlying pulmonary conditions, and immunosuppression).
Tarrant County Public Health and our neighbors have confirmed community spread of COVID-19 in persons with none of the previously identified COVID-19 risk factors, including travel to endemic areas or contact with a known case. Tarrant County has recorded 53 COVID-19 deaths so far. On March 25, 2020, that number was two.
Many facets of COVID-19 responses have been frustrating, and guidance has changed frequently and materially at times throughout our short history with this virus, but reliable sources of information continue to be the CDC, Johns Hopkins, and the WHO.
The CDC’s Coronavirus 2019 Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings is a highly readable document which emphasizes three key messages:
Decreasing traffic throughout healthcare facilities;
Isolating symptomatic patients as soon as they are flagged through screening procedures;
Protecting healthcare workers and other frontline workers by limiting staff caring for COVID-19 patients; prioritizing respirator masks and airborne infection isolation rooms, or negative pressure rooms where possible.
Most of us are old enough to remember at least one recent outbreak, but COVID-19 will be noteworthy in our history for the scale of its disruption of our lives and work, and for the lessons we learned about how to better prepare for the next such crisis.
Commercial payers have temporarily modified prior authorization timelines to help physicians care for patients during the COVID-19 emergency.
Below is an overview of some payers’ COVID-19 prior authorization policies:
Blue Cross and Blue Shield of Texas is temporarily extending approvals on services with existing prior authorizations until Dec. 31. This applies to services originally approved or scheduled between Jan. 1 and June 30. It applies to most nonemergent elective surgeries, procedures, therapies, and home visits for all group, fully insured, retail, self-funded, and Medicare Advantage members..
Aetna is approving prior authorization requests for commercial members for nine months instead of the standard six months. Physicians who already have received an approval for six months and plan to go over that time need to call Aetna to extend it for an additional three months. Aetna also will review precertification requests for elective procedures because the approvals are effective for a predetermined length of time.
Cigna: For prior authorization requests received March 25 until at least May 31, Cigna is temporarily increasing the authorization window for all elective outpatient services from three months to six months. This applies to all prior authorization requests received for all Cigna lines of business. Elective outpatient prior authorization decisions made between Jan. 1 and March 24 will be assessed when the claim is received and will be payable as long as it is within six months of the original authorization.
UnitedHealthcare has instituted a 90-day extension of open and approved prior authorizations, including those for many physician-administered drugs, with an original end date or date of service between March 24 and May 31 for services at any setting. This applies to all individual and group health plans, and Medicaid and Medicare Advantage plans, and to in-network and out-of-network existing prior authorizations. Approvals issued on or after April 10 will not be subject to extension. If a prior authorization approves the number of visits or services, the physician must obtain a new prior authorization for additional units, visits, or services beyond what was approved in the original authorization.
Tarrant County Public Health (TCPH) today reported five more COVID-19 deaths. The deceased include a man in his 70s and a woman in her 80s from Fort Worth, a woman in her 30s and a man in his 60s from Arlington and a man in his 90s from Grapevine. All but one had underlying health conditions.
Tarrant County now has 95 confirmed deaths from the COVID-19 virus. 735 people have recovered.
“As always, these deaths are sad and difficult for us to report,” said Tarrant County Public Health Director Vinny Taneja. He encouraged residents to continue to follow these Public Health guidelines:
Stay home as much as possible. If you do go out, cover your mouth and nose with a mask or scarf.
Practice social distancing – stay six feet away from others when you are out.
Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
Don’t touch your eyes, nose, and mouth with unwashed hands.
Avoid contact with people who are sick.
If you have difficulty breathing, or a persistent fever, call your doctor or healthcare provider.
Cover your cough or sneeze with a tissue or your sleeve.
Frequently clean and disinfect touched objects and surfaces.
Tarrant County has three COVID-19 community testing sites operating in Fort Worth and Arlington. Appointments are available Monday through Friday. To do a self-screening and make an appointment, go to covidtesting.tarrantcounty.com
COVID-19 causes respiratory illness with cough, fever, and shortness of breath, and may lead to bronchitis and severe pneumonia. For more information go to coronavirus.tarrantcounty.com or call the Tarrant County Public Health information line, (817) 248-6299, 24 hours a day, seven days a week.
The Collin-Fannin, Dallas, Denton, Grayson, and Tarrant Medical Societies have partnered to form the North Texas Medical Society Coalition (NTMSC), one of the largest physician-led COVID-19 alliances in the southern United States. With over 11,500 members, the NTMSC will collectively advise and inform North Texas communities with scientifically based information.
Knowledge of COVID-19 and the optimal treatment approach is constantly evolving. The goal of this coalition is to provide a united voice for physicians in the North Texas region at this critical time. Doctors throughout North Texas are working on getting scientifically-based recommendations to the community on safe practices and managing healthcare. By banding together, NTMSC hopes to augment their reach to patients and to serve as a voice of clarity at a time when medical information is coming at an overwhelming pace, often leading to confusion.
North Texas infection rates have increased to more than 9,000 COVID-19 cases, while to date, Texas has 33,369 confirmed cases statewide.
“It is becoming increasingly difficult for the public to wade through a large amount of information coming rapidly from different sources and to determine what is accurate, what is important, and what is applicable to North Texas and individual families and businesses. Physicians are best positioned to use our knowledge and experience to provide recommendations that the public can trust,” states Dallas County Medical Society President-elect, Beth Kassanoff, MD.
As their first recommendation, NTMSC proposes a continuation of physical distancing practices. Texas leaders moved quickly to implement social distancing early on in the pandemic. Because of this, Texas avoided the catastrophic surge of COVID-19 as experienced in other states. NTMSC believes it is imperative that civic and business leaders, and the community as a whole, continue to practice physical distancing to avoid a resurgence of COVID-19. Failing to do so may result in COVID-19 infections at rates that require hospitalization, intensive care, and medical equipment that exceed our resources.
North Texas physicians understand that citizens live, work, and play throughout a large region and are working together with area healthcare partners, including hospitals, public health departments, and business leaders, advising on medical recommendations related to reopening business and social activities. Our physicians are following medical science, tracking public health data, and adhering to CDC guidelines for population testing, contact tracing, and treatment recommendations for COVID-19 and non-COVID patients.
About North Texas Medical Society Coalition:
The NTMSC represents more than 11,500 physicians in the communities of Collin-Fannin, Dallas, Tarrant, Denton, and Grayson counties. Founded in 2020, The NTMSC works with community healthcare partners including public health departments, hospitals, and business leaders, to advise on medical recommendations to serve the health care needs of the residents of North Texas.