Are you reopening your medical practice for in-person visits? Here are three long-term telemedicine strategies to improve practice revenue and ensure compliance.
To say that COVID-19 has shone the spotlight bright and center on telemedicine is an understatement. Even as medical practices reopen doors to welcome back patients, telehealth remains a vital patient care channel for the foreseeable future.
The demand for telehealth is estimated to increase by more than 64 percent in the U.S. this year. There will be more than one billion virtual care visits, including 900 million telehealth consultations for COVID-19. Those are significant numbers given that at the start of 2020, only 24 percent of U.S. healthcare organizations had an existing virtual care program.
For most physician practices, the adoption of telemedicine in response to the COVID-19 outbreak was a ‘jump in, learn to swim later’ response. Since then, physician practices have figured out the basics, i.e., which types of consultations can be done virtually, how to prepare for virtual visits, and how to bill telemedicine.
Yet, telemedicine has its own challenges – most notably, the risk of erroneous medical billing, claim rejection, and possible regulatory issues. To mitigate these challenges and to boost practice revenues we recommend you adopt the following telemedicine strategies at your medical practice.
Telemedicine Strategy 1 – Be Thorough in Documenting Every Telemedicine Visit
We are still in crisis mode, and telemedicine billing relaxations are likely to continue until September 2020. However, once the dust settles, there may be renewed regulatory focus on telemedicine claim submissions. Telemedicine claims processing is unchartered territory for payors as well. The insurance industry has never handled such diverse telemedicine claims and in such massive volumes.
To safeguard your practice from future scrutiny and to ensure that you collect billed claims at the earliest, the rule of thumb to follow is this – document every aspect of a telemedicine visit.
Here is the list of information that you must record for every telemedicine call –
- The type of telehealth – audio only, or audio and video.
- Consent of the patient to see you via a virtual consult.
- Patient consent for the use of technology (e.g., FaceTime, Skype) that is not HIPPA compliant.
- Pre-existing conditions.
- Purpose of the telemedicine visit.
- The date, time, and place of service of the telehealth appointment.
- Length of the call.
- Health information and reports shared by the patient during the call.
- The virtual assessments made – record every detail evaluated while diagnosing the patient and the conditions ruled out.
- Follow-up tests and visits advised to the patient.
Telemedicine Strategy 2 – Scrutinize Your Telehealth Claims
To understand the impact of telemedicine on your practice revenue, you must analyze the telemedicine claims submitted. Some of the questions you should be asking are –
- Is the telemedicine claim approval rate comparable to the claims approval for similar office visits?
- What is the difference in telemedicine claim approvals across different payers?
- What are the reasons for telemedicine claim rejection? Was it a lack of documentation? Was it due to incorrect codes and modifiers?
Telemedicine Strategy 3 – Understand the Legal and Compliance Implications of Telemedicine
The federal government is pumping hundreds of millions of dollars to support healthcare organizations offering telemedicine. However, the complex web of federal and state regulations on healthcare can make the compliance landscape a tricky one to navigate. In the pre-COVID-19 pandemic, enforcement authorities have imposed civil and criminal penalties on providers for non-compliance and telemedicine billing frauds.
It’s advisable to seek legal counsel on the changing telemedicine laws and compliance requirements to understand the implications for your practice. Ensure that your telemedicine policies are well-documented and shared with your patients and staff. Conduct regular compliance training for all staff involved in the administration of telemedicine services and telemedicine billing. Also, regularly audit your telemedicine processes to ensure that existing compliance policies are effective.
Does your in-house billing staff have the training and/or the time to handle telemedicine billing? Are they updated on the changes in payer reimbursement policies? Given the dynamic reimbursement landscape, you can outsource medical billing to a company with staff dedicated to telemedicine coding, billing, and claims tracking. Contact us to learn more.