Telemedicine Billing: 7 Crucial Considerations to Streamline Your App

Telemedicine, once a cutting-edge method of medical care, has quickly advanced into a useful choice for many healthcare providers today. According to a recent AMA report, the adoption of telehealth services has increased overall by 53%, faster than that of any other kind of medical care solution.

In this article, we’ll look at a few key things providers need to know about billing for their telemedicine practice.

1. Connect your telemedicine platform with medical billing software

In order to decrease errors, increase profitability, and speed up claim reimbursements, healthcare organizations can customize both their billing and coding processes using a powerful medical billing software.

The following are some of the key advantages of incorporating medical billing software with your telemedicine platform:

A medical billing software in place allows patients to pre-register, which increases time savings. Since every new patient you onboard fills out an intake form and provides information about their insurance before their first appointment, this saves you a tonne of time. Following this process also saves a significant amount of time for both you and the patient.

Streamlined Workflows – A medical billing programme aids in sending the claim to the other party right away. In order to expedite filing, it also enables the healthcare provider to post outlay at the point-of-care. The electronic tracking feature that comes with a medical billing software speeds up the electronic claim processing and also enables your financial team to periodically update the cash flow management activity.

2. Confirm in advance that telemedicine is covered by the patient’s insurance

It is always advisable to check your patient’s insurance coverage for telemedicine reimbursement before the patient’s first visit when beginning your telemedicine journey. You may need to put in a little extra effort, but you only need to do it once for that particular policy.

One thing to keep in mind is that whenever you call the payer, you should always have a form for verifying your telemedicine insurance on hand. As a result, it will be considerably simpler for you to record the representative’s responses.

Be sure to write down the call reference number as well.

You can use this information to settle the claim in the event that the payer later rejects it.

3. Know the Telemedicine Guidelines for each Payer

If you’re tackling billing with the major types of payers (Medicaid, Medicare, Private payers), this part may seem a little intimidating at first. However, the most effortless way to learn what each payer wants for telemedicine is simply calling and asking the right questions.

  • Some of the questions you can consider asking are:
  • Which healthcare providers can bill for telemedicine?
  • Are there any restrictions on the number of telemedicine visits patients can have through the span of one year?

A few payers may have definitive answers to these concerns, but others may simply state that they cover telemedicine for a limited number of providers without imposing any further limitations.

Because these regulations differ greatly from state to state and payer to payer and because telemedicine regulations are rapidly changing as a result of the ongoing COVID-19 global pandemic, keep in mind that the insurance carriers’ representatives might occasionally be unsure when responding to some of your questions. Therefore, you might want to think about double-checking their responses.

4. Ask the Payer which CPT Codes are Acceptable for Telemedicine Billing.

Most payers now recommend that healthcare providers who are billing telemedicine use the appropriate evaluative and management CPT codes (99201 – 05, 99211-15) along with a GT or 95 modifier.

But as a provider, it’s important to keep in mind that Medicare covers a comprehensive list of CPT codes that are acceptable, and some private payers might require you to use the unique code for telemedicine, which is 99444. Depending on the states that your patient and the payer are in, this varies greatly.

5. To improve interoperability, store data in a centralized repository.

Cloud-based medical billing is one cutting-edge tool that could significantly streamline billing for your telemedicine platform. This solution provides the highest level of data security while reducing costs across the board.

Any authorized computer with a working internet connection can access the data stored on a remote server that hosts cloud-based billing software.

By allowing each member of your organization to access data with the purchase of a single contract rather than one for each system at each location your practice operates, this provides an additional layer of security for your billing data, safeguards it from breaches, and reduces overhead costs.

Providers and other authorized healthcare workers can also access information from the cloud at any time using mobile devices. This significantly improves overall outcomes and interoperability.

With cloud-based medical billing, medical professionals and their staff can spend more time on patient care, submit accurate claims, and receive payment without hassle.

6. Be familiar with facility fee billing

Most healthcare professionals who bill for telemedicine don’t necessarily need to be familiar with facility fees. However, if your practice is affiliated with a telemedicine programme that occasionally bills through Medicaid or Medicare, you should at least have a general understanding of how facility fees are calculated and what is required to be eligible for them.

For instance, a patient must visit an authorized originating site in the current Medicare telemedicine model in order to begin a telemedicine consultation with a provider at a different, remote site. For hosting the consultation, this specific originating site may then charge a facility fee.

7. Uphold the accuracy of the documentation

Finally, maintaining accurate documentation integrity is a very important step in the billing process for telemedicine consultations.

First, on the doctor’s note in question, it should be noted how much time was spent on each session. Level 3 and level 4 reimbursements in a virtual setting ought to be computed entirely based on the amount of time spent, not on physical examinations.

Providers should make sure that more than half of their telemedicine encounters were spent coordinating care rather than the other way around.

Everything from the active diagnosis to the differential diagnosis, associated risks, benefits, prognosis, instruction, and benefits of the treatment being administered should be covered in the doctor’s documentation. It should also address risk reduction, compliance, and coordination of care with other associated providers, if any.

The most crucial lesson for healthcare professionals to learn from this is that the documentation for telemedicine consultations must adhere to the same standards as those for in-person consultations.

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