Telehealth Billing Decoded by Medical Coding Experts

Doctors looking at an Xray on a tablet

Since the outbreak of the coronavirus pandemic, much has been written about telemedicine. While some practices may see telehealth as an interim solution to the lockdown, the reality is that many patients now expect their providers to have a telehealth option. In the last two months, the conversation has moved from ‘should we offer telemedicine?’ to ‘how do we implement telemedicine?’

Your Telemedicine Implementation Questions Answered

Whether you are implementing telemedicine for the first time or upgrading your telemedicine systems, you are bound to have questions. So here is a list of answers to help you make that transition.

Q1. Should you offer telehealth using a simple video-based app or opt for a more advanced telemedicine software?

That really is the first question clients ask us when they want to implement telehealth. The recent public health emergency related announcements made by CMS have made it possible for practices to offer telehealth services using video apps such as Skype and FaceTime.

That’s okay as a make-shift telehealth strategy as you try to deliver patient care in these trying times. But you must realize that the HIPAA security requirements were put in place to protect patient information, and using these apps can compromise patient data.

We strongly advise that you implement a telemedicine software that is HIPAA security compliant. For instance, is a simple, and secure way to start with telehealth.

Q2. What are the advantages of advanced telemedicine software?

So when we use the term advanced telemedicine software, what we mean is a software that integrates with your existing EHR system. Telemedicine software platforms (such as AdvancedMD) allow physicians to make notes during the patient session and then seamlessly integrate that information with patient records. The software also has the capability to create invoices, check patient co-pays, submit claims, and schedule patient appointments. So instead of toggling incongruent systems to make telehealth calls, record patient data, claim insurances, and check physician availability, you can do that seamlessly through one integrated advanced telehealth software.

The other big advantage is that since everyone at the practice (other physicians, nurses, billing staff) use the same system, they have access to information that is current – whether it’s a patient record or a physician’s appointments for that day.

Q3. Is telehealth costly to implement?

Telehealth does not require a big investment. EHR software usually has a built-in telemedicine feature that can be enabled at an additional cost. Please speak to your EHR software provider for more information.

As a standalone telehealth system, some of our clients have been very happy using, which starts at $35 per month for individual providers and $50 per month per person for clinic providers.

Q4. Are telehealth reimbursement rates the same as in-person patient consultations?

During the COVID-19 healthcare emergency, the Medicare reimbursements for E/M codes are the same as in-person consultations, as long as the claims are billed correctly. But the actual reimbursement rates will depend entirely on the payor.

Under normal circumstances, reimbursement rates for telehealth visits tend to be lower than in-patient visits for the same purpose.

But keep in mind that telehealth will boost your accessibility. Telehealth calls tend to be much shorter interactions, and therefore the channel allows you the time to see more patients per day. The technology makes you accessible to people who are located far away from your medical office and who may not come to you but for the option of telehealth consults. So you are able to care for more people than you otherwise would be able to without telehealth. What you may lose in per-patient revenue, you more than recover by developing a wider patient base, which is good for the sustainability of your practice in the long-term.

Q5. How do you convince patients to contact you via telehealth?

As of now, telehealth consults are the only option for most patients to talk to a physician. But yes, you will need a strategy to encourage more patients to use this channel. Please read our blog ‘5 Ways to Promote Telehealth with Your Patients’ for more information on migrating your patient base to telehealth.

Show Me the Money – Telehealth Billing Explained

How do you bill telehealth? That really is the big question facing practices that have just started with telehealth, which is why our billing experts are here to help.

Listen to this telemedicine billing video by Parul Garg (Vice President and Owner PracticeForces) and Holly Vogt (Director-Revenue Cycle Management, PracticeForces) as they answer the following:

  • Can you bill telemedicine for a pure audio call (i.e., if the patient does not have a video facility on their phone or computer)?
  • What is the claim approval rate for telehealth billing?
  • What is the place-of-service code for telehealth calls?
  • How can you claim physician-to-physician telehealth calls?
  • Should you ask patients to clear their outstanding dues during the current coronavirus crisis?

According to a recent article shared by telehealth provider AdvancedMD, it’s not just the younger generation of patients that are happy to use telehealth; almost 50 percent of patients older than 45 years of age are willing to try tele-visits. Telehealth is clearly the future of medical care.

PracticeForces is committed to helping the U.S. physician community in the fight against COVID-19.

If you found this information helpful, please spread the word by sharing on social media. If you have any further questions on telehealth medicine implementation or telehealth billing, we’d be happy to help.

Contact us for a consult with our team of telehealth experts.

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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