Telehealth

Telehealth is the distribution of health-related services and information through telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions.

Shift to telehealth

While telehealth has been prevailing for a long time but used minimally, most healthcare providers, from large medical facilities to solo practitioners started jumping on the telehealth bandwagon in early 2020 to address the pandemic and shift from in-person care to virtual care. With COVID-19 in full swing in 2021, telehealth services have taken a front seat in the field of medicine.

3 Ways to deliver telehealth services

Telehealth services can be delivered synchronously where real-time communication between patient and doctor via phone or video conferencing, asynchronously where messages are recorded and shared with the provider later, and remote monitoring wise where measurements such as weight or blood pressure are sent to the health care provider.

Benefits of telehealth

Telehealth has its own benefits including cost-saving, convenience, and the ability to provide care to people with mobility limitations, or those in rural areas who cannot easily reach a medical facility.

Telehealth has become indispensable during the pandemic because of the fear of spreading and catching the virus during in-person medical visits.

Telehealth reimbursement by insurance companies

Now, even though a huge chunk of the population is quite keen on benefitting from telehealth services, the question that pops up in most minds is if their insurance covers telehealth or not? In this regard, one may consult the American Telemedicine Association’s website to learn about one’s state laws related to reimbursement of telehealth services by private insurance companies.

For the sake of prevention of the spread of COVID-19, the federal, as well as state governments, have focused on loosening restrictions on telehealth in the Medicare and Medicaid programs, provider licensing, online prescribing, and written consent being a few of them. Moreover, many private insurance companies have voluntarily addressed telehealth in their response to COVID-19, focusing on reducing or eliminating cost-sharing, broadening the coverage of telehealth, and expanding in-network telehealth providers.

Billing telehealth services

To start the billing cycle for telehealth, providers must first clear the use of telehealth with the patient’s insurance company or other payers. In most cases, this involves a phone call to the payer to verify coverage and the specific listing of a code used to identify the place of service and the particular telehealth service to be provided. As mentioned, different payers and different legal entities hold different requirements to determine eligibility; depending on the coded procedure, you may need to meet specific distance, provider-patient relationship, patient consent, and other qualifications for the payer to cover the telehealth visit.

Relevant CPT/ICD codes are assigned to a telehealth procedure or interaction and the payer is billed accordingly. Due to a rapid increase in telehealth services as well as a surge in COVID-19 cases, several telemedicine CPT codes are being developed.

After the payer receives the billed claims, a medical claims adjuster determines approval, denial, or failure of the claim based on the necessity of the service as well as the eligibility of the patient’s coverage. If the claim is approved, the insurance company provides reimbursement based on a pre-approved rate whereas denied/failed claims are returned to the provider who must then make the necessary corrections and resubmit the claim.

Future of telehealth

With the ongoing battle against novel coronavirus and its variants in full swing, it is a little early to speculate whether telehealth is here to stay or not. Will its use be reduced considerably with the defeat of COVID-19 or will it have earned a permanent spot in our daily lives, one can only make tentative guesses. However, since February 2020, telemedicine grew from less than 1% of primary care visits to nearly 43.5% in April 2020 and one must use this development to advance one’s medical business.

Importance of outsourcing telehealth billing

The high time to outsource your telehealth billing is now if you as a solo practitioner or healthcare facility want to make the most out of telehealth while it lasts and takes your business to new heights. Outsourcing your telehealth billing will enable you to provide the best healthcare service, make optimal utilization of EHR, have updated knowledge of changing codes, produce error-free, time and cost-efficient work, and increase revenue for the company substantially.

At Avernus Medical Billing, we specialize in providing Medical Billing and Coding Services all over the USA with the help of certified professionals who will ensure that your telehealth services are billed and charged, minimizing the risk of losing income and federal non-compliance. Call us at +1 817-989-6949 or send us a mail at info@avernuscorp.com and we will be delighted to answer your queries.