Common Medical Billing Challenges Related to Telemedicine

(prsubmissionsiteMay 15, 2020  Medical technologies have developed not only in terms of equipment but also in providing healthcare services at the ease of one’s hand. Telemedicine is a term referring to giving medical advice and prescriptions via video calling or other convenient methods.

TeleMedicine practice has reached to more than three-fourths of the hospitals in the United States. The practice of telemedicine reduces costs and is convenient for the patient.

The combination of technology and healthcare skills raises questions for the insurers as to how much should they cover for their clients. Some insurance companies cover the telehealth costs to a certain extent, while others resist paying anything.

  1. Specific conditions for reimbursement are required:

Insurance firms have highlighted a few requirements for the telehealth service to be reimbursable.

Medicare, the federal program providing healthcare to differentially abled and above 65 residents, requires the beneficiaries to be living in certain rural or outside a metropolitan statistical region to be considered for reimbursement.

Moreover, the patient needs to be present at a nearby “originating site”, which includes nursing homes or rural health clinics, etc.

2. Lack of pay parity:

The terms and conditions of private insurance providers do not guarantee payment similarity in the telemedicine and in-person scenarios.

Most US states allow private insurers to reimburse medical costs while emphasizing that refunded amount should not exceed the cost of reimbursement if the beneficiary were treated in-person.

No enforcement is provided on the parity laws in these states, while others do not allow private insurers to stand for reimbursements.

3. Insufficient information about various insurance providers:

Although insurance providers such as Medicare, Medicaid and private insurance companies fall under the same jurisdiction, the rules related to medical billing of telehealth services may be completely contrasting.

Not all insurances have caught with the trend of telemedicine, while others face great discretion in setting a fixed value to reimburse for telehealth facilities.

4. Lack of expertise of the telehealth provider:

Telemedicine could greatly boost the costs of treatment if the telemedical staff misdiagnoses the beneficiary. It could raise the stakes for reimbursement to be covered by the insurer.

Quality of counselling may greatly vary from one provider to the other. Wrong or unnecessary prescriptions could lead to a worse health condition of the patient, due to which he might have to attend urgent care. This unnecessary billing leads to the discretion of the insurance firms.

5. Role of intermediaries:

These are links between the healthcare facility and the patient. These vendors provide technology to transfer a required service from the provider to the beneficiary over long distances.

The insurers need to attend to the costs of the links as well because they need to provide reimbursement for healthcare service as well as technology.

Conclusion:

While attending to the funding obstacles, it would be a reasonable consideration that telemedicine has also provided effective results, as in the case of the decreasing number of patients in the emergency rooms. In this healthcare scenario, on the front-end, expert education of the medical practitioners should be considered.

This will help the patient to gain useful knowledge and will lead to a decrease in the discretion of insurers for tele-medical reimbursements.

About 24/7 Medical Billing Services:
We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.

Contact: 
24/7 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com

 

 

 

Most Common ICD-10 Codes for Telemedicine Service Providers

(prsubmissionsite) April 29, 2020 A business needs to adapt itself as per the changes in the environment. In this highly competitive world, hospital, doctors, and medical service providers need to consider smart and well-developed telehealth strategies.

The world is facing a pandemic and there is a huge downfall in the economy because of this. The doctor and the medical service providers are struggling a lot for the delivery of medicines and services. So, thinking whether telemedicine fits into your practice isn’t an option now. It has become important to adopt it.

Telehealth includes everything from managing complex and high-risk situations to providing high quality convenience care, effectively and efficiently.

Telemedicine is used for monitoring people in the rural and urban areas who are suffering from chronic illness. The standard of the telemedicine is the same as in person treatment. It is also safe and effective for the patients and is intended to be inexpensive and convenient. It is not a new concept. Many specialists and medical service providers have already adopted and implemented in their medical practices.

Why to choose telemedicine?

  • Physical presence is not needed. A patient can receive the treatment even if he is not there where the doctor is located.
  • It is cost effective.
  • It helps in saving a lot of time and the patient can get treatment on an immediate basis.
  • There is no compromise in terms of the quality and standards, it is just the same as the in-person treatment.
  • It is one of the safest and effective methods for the treatment of patients.

Telemedicine Specific Billing Code

Code 99444 – The code used for online evaluation and management services. It helps in telling the payer that the consultation has happened online and there aren’t much details about the treatment and all. This in turns helps the healthcare providers and insurance companies to keep a record.

E&M Code and GT Modifier

Code 99201-99215 – This is a 15-20 minutes’ outpatient office visit for either new or already established patients.

The GT Modifier helps in keeping a track and lets them know that the visit has taken place virtually on this telemedicine platform. This in turns helps in keeping and maintaining a record.

Apart from that there are various other codes that are used to offer the telemedicine services to the patients.

We at 24/7 Medical Billing Services are offering this telemedicine services to the hospitals, practice, and medical billing service providers to help them in easing the work.

Is your practice struggling with revenue & facing denials due to improper coding standards?

Get in touch with us today & we guarantee improving your practice performance.

About 24/7 Medical Billing Services:

We are a medical billing company that offers 24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.

Contact: 
24/7 Medical Billing Services
Tel: +1 888-502-0537
Email: info@247medicalbillingservices.com