Hopefully, we are on our path of overcoming this global beast. In the best-case scenario, quarantines, masks, and social distancing will soon become relics of the past. However, telemedicine is undoubtedly here to stay.
Today, we would like to share three tips for telehealth billing that can help you maximize your revenue from telemedicine services regardless of the circumstances:
I. Understand the difference between telehealth service types
Different types of virtual care are labeled by a collective term of telemedicine. The CMS has outlined three types of virtual care services — the classic telehealth visit, virtual check-ins, and e-visits.
Telehealth visits involve interactive audio and video telecommunications system that connects the provider and patient in real-time.
Virtual check-in refers to a brief 10-minute communication between the patient and the provider either by a phone call or via the exchange of a video or digital image to determine whether an office visit is required.
E-visit is non-face-to-face communication between provider and patient that occurs via an online patient portal.
It’s important to understand these differences because the type of visit is directly related to how certain services must be billed, and how much would insurance carriers pay for them.
II. Keep up with federal, local, and commercial reimbursement policies
Currently, many payers have eased their coverage limitations when it comes to telemedicine. For example, some insurance companies cover such services even out-of-network. However, all this will soon come to an end. In the near future, most payers will cover telemedicine only under certain conditions. Therefore, like with any other service, we recommend that you double-check the patient’s eligibility before a virtual visit. More importantly, the CMS is rolling out new payment policies and billing requirements concerning telemedicine nearly every month.
III. Know how to code
Telehealth services differ by their characteristics. Different payers require different Place of Service (POS) codes for telemedicine. For an example, at the beginning of the PHE, Medicare used POS code 02 for telehealth regardless of the specifics. It has recently requested this POS code to be used only when a virtual visit is rendered in any place other than a patient’s home. Be sure to check with payers as their telehealth requirements for billing, including codes and modifiers, may vary and continue to change.
But why would you care about all this in the first place?
At WCH Service Bureau, we strive to provide a top-quality all-encompassing medical billing solution to healthcare professionals. We are always on the same page with the most significant billing and payment-related policy updates.
Interested? Contact us!
