Facts That Nobody Told You About Telehealth Billing Services

Facts That Nobody Told You About Telehealth Billing Services

Telehealth is the new healthcare technique that allows doctors to content with patients using different online tools like video and audio meetings, electronic consultation, monitoring remote patients, and other wireless communication tools.

Telehealth has allowed people to access healthcare services from doctors and physicians no matter where they are. It is increasingly becoming the number one choice of a lot of people across the country. With the pandemic situation on hand, many doctors and clinics are shifting their services to Telehealth to ensure the safety of both their staff and the patients. However, billing of telehealth can be tricky especially with the constant change in rules and addition of new guidelines for telehealth coverages.

The telehealth guidelines are still in the process of forming and differ from state to state and from payer to payer. The reason for these rapid changes is because of the current COVID-19 pandemic that made the expansion of telehealth into the daily routines of people a necessity. Several people have the virus symptoms or are vulnerable and at threat of getting the virus which makes it difficult and unsafe for them to travel to a clinic for check-ups. By using telehealth, the spread of the virus to the patients and hospital staff getting exposed could be minimized.

Below are some interesting facts that you might not know about Telehealth billing services.

The majority of Private Payers in the U.S provide coverage for telehealth services. Along with the Medicare major payers around the country and now covering for telemedicine services or at least part of it. The policies of many states are changing, and they are an increased focus on telehealth. Around 35 states have passed the ‘parity law which means that insurance companies are supposed to provide the same level of coverage for telehealth and traditional healthcare without any discrimination. However, the payment parity varies from state to state. Therefore, check your state and district laws on parity payment. Due to the COVID-19 situation, many states have expanded their laws on telehealth services and many companies are changing their reimbursement policies of Telehealth.

The Restriction on Telehealth Billing Services

When it comes to reimbursement, payers might put only cover a certain type of technology using for telehealth hence it is important to check with your payer to make sure the technology you are using will be reimbursed for. This also goes for Medicare and Medicaid coverage. You can check their official page to see what technologies can be used for telehealth that can be reimbursed. For Medicare patients, telehealth with a video and audio technology system.

New Telehealth Guidelines for Medicare 

There are certain new guidelines because of the current public health emergency due to the COVID-19 pandemic. All Medicare beneficiaries will receive telehealth coverage no matter their location. Similarly, you are not required to have any pre-existing doctor-patient relationship to receive the coverage. Telehealth visits can be provided using everyday use of communication tools like Facetious and Skype. In the new guidelines regarding the telehealth billing procedures, new codes for cardiac and mental health services have been added. This means physicians can now bill for these services as telehealth for all the beneficiaries of the Medicare Program.

Telehealth 1135 Waiver 

Telehealth visits for offices, hospitals, and other visits are now covered under this new waiver. Providers including doctors, practitioners, clinical psychologists, nurses, and clinical social workers who are licensed can provide telehealth services to their patients under the new 1135 Waiver. Before the 1135 Waiver, the beneficiaries of Medicare were only provided reimbursement for telehealth services on a very limited basis. However, the Center for Medicare Services was already improving the virtual healthcare services for beneficiaries. For example, the beneficiaries of Medicare Plan B receive pays for their E-visits to clinics.

Outsourcing Telehealth Billing Services

With the use of Telehealth, the outsourcing of telehealth billing is also growing day by day. A third-party telehealth billing company has experienced staff which means there are fewer chances of claim denial, fewer mistakes, and more accuracy. Similarly, a third party will have more focus on training staff to carry out the telehealth billing more accurately reducing the cost and increasing the revenue potential.

Telehealth is quickly growing into the most uses form of healthcare. Telehealth has greatly enhanced the current healthcare standard and rules and regulations for Telehealth billing are constantly expanding into different healthcare areas.

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