A Complete Guide to Telehealth Coding & Billing
Overview :
In the past few years, the internet has transformed modern life in a variety of ways. Several telehealth tools are available to help you manage your health care services in a proper manner. Here in this blog, we will share all the necessary details concerning telemedicine and the right telehealth tools to choose for your healthcare practice.
Summary :
- Telemedicine is the practice of using communication technologies by a medical professional for diagnosing and treating patients remotely.
- Due to COVID-19, telemedicine is changing almost every day, making it challenging to keep up with the current coronavirus crisis. Experts are still working on making the guidelines for billing telemedicine.
- The most reliable approach to ensure that you are getting paid for your telemedicine services is to call and verify coverage with the patient’s insurance before their first telemedicine visit.
- There are various ways to conduct telehealth and virtual visits, including Telehealth Visits, Telephone Visits, Virtual Check-Ins, E-Visits, and Remote Monitoring.
- It would help if you considered several factors while choosing telehealth tools, including implementation and cost.
- Although telehealth encourages better-coordinated care, it is also responsible for increasing the risk of fragmenting health care.
What is Telemedicine?
In telemedicine, medical professionals offer healthcare services in the farthest areas by utilizing communication technologies. They use several tools to exchange critical data to diagnose, treat, and prevent injuries and disease. Besides, this information helps health care providers to perform research and evaluation for their continuing learning, all in the benefits of advancing people’s health.
Things You Should Know Before Billing Telemedicine
Billing for telemedicine can be complicated and tricky. Due to COVID-19, telemedicine is changing almost every day, making it challenging to keep up with the current coronavirus crisis. Experts are still working on making the guidelines for billing telemedicine. The rules for billing telemedicine are changing quickly and differ from payer to payer. Probably we will soon get to the point where we would have clear guidelines for billing telemedicine for all payers. But medical billers want answers to their billing and coding questions right now. How should they bill telemedicine? What codes should they utilize? How does telemedicine reimburse? What are the limitations they should watch out for?
Major Private Payers Cover Telemedicine
All the significant commercial payers in the US are efficiently covering telemedicine. Medicare also covers telemedicine, and with the current pandemic situation, the rules for telehealth have expanded. What was not allowed by the government in the previous days is allowed today.
Verify That Patient’s Insurance Covers Telemedicine
The most reliable approach for ensuring that you are getting paid for your telemedicine services is to call and verify coverage with the patient’s insurance before their first telemedicine visit. Ensure that all the representative answers have been documented on the form with the call reference number; you can utilize it to fight a denied claim in the future.
How Will You Use Telehealth and Virtual Visits?
There are numerous methods for conducting telehealth and virtual visits. These types of visits are listed below:
- Telehealth Visits: In this type, real-time, synchronous audio and video telecommunications technology is utilized. The services can be provided to the patient using only the telephone.
- Telephone Visits: It is the encounter between provider and patient traditionally via telephone.
- Virtual Check-Ins: Brief and short meeting (5-10 minutes) held with patients through telephone or other devices for deciding whether an office visit or other service is required. The patient’s review is recorded in the form of video or images submitted by a patient.
- E-Visits: It is an asynchronous office visit between patient and provider, traditionally via a patient portal or secure email.
- Remote Monitoring: In this type of virtual visit, remote monitoring of physiologic parameter(s) is performed through several medical devices.
How Do I Choose the Right Telehealth Tools?
Once you have decided to include telehealth in your service list, you must determine the type of visits you will offer for your practice. You need to consider various factors while choosing a telehealth tool or tools, including:
- Implementation
It is essential to analyze some crucial steps before starting the implementation process. Is it easy to set up? How much time will it take? Does it need additional software installation? Or is it cloud-based? In the current pandemic situation, you require a solution that can run on an immediate basis. Thus, a cloud-based system is considered the best choice right now.
- Cost
Some systems add additional costs for set-up, equipment, ongoing upgrades, training, and support. They have a limited number of licenses and the price increases with any more addition. It will help if you look for a system with a subscription fee by practice or by provider covering all expenses for one price with no additional add-on fees.
The Limitations of Telehealth
Although telehealth encourages better-coordinated care, it also increases the risk of fragmenting health care. As a result, a lack of cooperation is caused by healthcare providers. Fragmented care may also lead to gaps in care, improper use of medications, overuse of medical care, or unnecessary or overlapping care. Usually, telehealth services’ potential benefits may be restricted by other elements, including the ability to pay for them.
Insurance reimbursement for telehealth services differs from state to state and insurance type. Additionally, some people who would benefit most from advanced access to care may be restrained due to costly mobile devices or regional internet availability.