Telemedicine Billing

Delivering high-quality patient care through telemedicine or a telehealth platform has become a necessity for most providers. You will be happy to know that telemedicine allows healthcare professionals, such as doctors, to evaluate, diagnose, and treat their patients virtually using telecommunications technology. 

You may know that this approach to patient care has been through a major evolution in the last decade, becoming a highly important element of the US healthcare infrastructure. Note that in a matter of only a couple of weeks, telemedicine has shifted from a mere convenient and cost-effective care option for patients to the singular focus of US healthcare delivery. 

Did you know that for many independent private healthcare practices in the country, the response to the coronavirus health pandemic marked their foray into using telemedicine services? But for most, it is imperative for the success of their practice and the health of their patients. For example, telehealth and telemedicine have gone into hyper-drive for ophthalmologists and optometrists during the pandemic.

However, it is worth noting that telemedicine billing can be tricky and challenging. Also, with the COVID-19, telemedicine and related laws are changing almost on a regular basis, making it hard for practice managers to keep up. 

It is no secret that telemedicine is medicine’s most significant shakeup in history. Did you know that the shortfall of primary care physicians and doctors over the coming decade could be up to 35,000? These challenges and opportunities call for better technology as well as new and improved approaches to treatment.

Telemedicine vs. Telehealth

While many people often use the terms telehealth and telemedicine interchangeably, there is an important distinction between the two. The terms telehealth and telemedicine spark plenty of debate among professionals in the healthcare field. One of the main reasons for this debate is the varying definitions of the terms themselves. 

Note that some experts consider that telemedicine is physician-focused while telehealth includes all healthcare professionals in general. Keep in mind that the term telehealth encompasses a wide range of services and technologies in order to provide patient care as well as improve and enhance the healthcare delivery system. 

On the other hand, telemedicine involves using electronic communications and software in order to provide healthcare and clinical services to patients without in-person visits. Telehealth is a little different from telemedicine. This is because it refers to a much broader scope of remote health services than telemedicine. 

Telemedicine Billing- Tips and Things You should know

Here are the top tips and things you should know about telemedicine billing.

All Major US Private Payers Cover Telemedicine

As a medical practice owner or manager, you will be happy to know that all major commercial payers in the US, such as Blue Cross Blue Shield, and Humana, cover telemedicine. Did you know that Medicare also covers telemedicine?

Documentation is Key

It is vital to have processes and procedures in place in order to ensure accurate and complete documentation needed to support the coding of services and billing. Note that crucial documentation for telemedicine billing usually includes the technology used, length of visit, as well as patient consent to use the technology.

Store Data on a Single Centralized Repository 

Cloud-based medical billing is one of the state-of-the-art tools that can streamline and optimize billing for your telemedicine platform. Did you know that this solution can offer you optimal data security and considerable cost savings in many areas? It is worth noting that cloud-based billing software usually runs on a remote server. 

You can access the information stored on it through any authorized computer with a valid internet connection. And this provides you with a supplemental security layer for all your billing data and protects it from data breaches and slashes overhead costs.

Know all the Telemedicine Guidelines for each Payer

Sometimes, this part may seem daunting at first. This is especially true if you are handling telemedicine billing in your organization with all 3 major kinds of payers (Medicaid, Medicare, and private payers). 

However, here are some things that you should ask to make it simple:

• Which health providers can bill for various telemedicine services?
• Do you specifically cover or provide live video telemedicine?
• Are there any specific restrictions and conditions that you have to meet before a patient qualifies for telemedicine, such as informed written patient consent?

While some payers in the US may have concrete and clear answers to these questions that specifically define their telemedicine coverage, other payers might just state they cover telemedicine for specific providers. This is why it is best to call that payer and seek their guidance.

Audit Your Denials

You should continually and thoroughly audit your telemedicine claim denials in order to identify adequate coding and clinical documentation needed for government as well as private payers. There is no doubt that addressing the reasons behind denials soon will lead to more compliant medical coding and higher reimbursements for your telemedicine services.

Change in Telemedicine Billing Laws because of COVID-19

You know that COVID-19 brought telehealth, telemedicine, as well as remote patient monitoring to the forefront of the modern medical field. Because of the coronavirus, many Medicare restrictions and limitations surrounding the use of telemedicine and telehealth services have been lifted during the pandemic. 

A few fundamental changes are as follows:

• Physicians will usually be paid by Medicare for audio-only phone calls 
• There is an expansion in telehealth services, and now these services include emergency department visits 

We live in a digital and technologically advanced world, which is one of the significant factors separating this pandemic from the previous ones. 

The authorities have significantly relaxed and even suspended state and federal regulations and laws that previously put up various barriers and obstacles to telemedicine and telehealthcare.

Why Outsource Your Telemedicine Billing

As a healthcare provider, you may not have the internal resources and expertise in order to maintain a high level of accuracy and precision when it comes to the telemedicine billing process. If you would like to lower the number of denied medical claims from insurance companies while streamlining and optimizing telemedicine billing procedures, you can use many outsourcing options to improve your business bottom line. 

You will get several advantages and benefits from outsourcing your telemedicine billing process to an experienced and reputable medical billing firm, such as UControlBilling. Some benefits of outsourcing are as follows:

Up-to-date Expertise and Experience

As the medical coding and billing profession in the US has experienced several abrupt changes over the last couple of years, especially in light of the COVID-19 pandemic — the expertise and experience of an industry-leading third-party firm can be invaluable in terms of staying updated on the latest laws, regulations, and procedures. 

Professional billing companies have effective revenue cycle management services offered by experienced and knowledgeable professionals who can proficiently handle various types of medical claims.

Short Turnaround Times 

In many cases, it can take several days for a medical claim to get submitted to a payer. Note that these delays may ultimately lead to significant cash flow problems and issues. However, if you rely on an outsourced workforce comprising medical billing experts and specialists in your service, you will submit a majority of your medical claims within hours rather than days.

Reduce Costs

It is no secret that maintaining an in-house medical billing department often comes with high staffing costs. For example, employee benefits, workers’ comp insurance, and overtime pay are significant expenses. 

Rather than staffing your own medical billing department, you should outsource your telemedicine billing as it allows you to pay considerably less for expertise. 

And the money that you save by avoiding the various overhead costs associated with in-house staff members can easily be reallocated into growth initiatives, such as marketing and IT upgrades.

Hire an Experienced Telemedicine and Telehealth Billing Firm 

If you are like the countless healthcare professionals and physicians who have added telemedicine and telehealth to their services list, it is likely that you will experience more medical billing uncertainty and complications than ever.

Rather than taking on the complicated task of providing training and adjusting to regular payer regulation changes, you should hire an experienced and reliable telemedicine billing company. Note that a third-party team can focus better on the various nuances of your telemedicine billing while you focus on the patients. 

Professional billing companies, such as UControlBilling, know all the ins and outs of working with all the top insurance payers. They take the time and resources to verify eligibility, as well as research and analyze every process in order to maximize your payments.

Final Thoughts 

Regardless of the size and nature of your medical practice, outsourcing your telemedicine and other medical billing needs will help reduce your overheads, allowing you to focus more on the everyday concerns and issues of running your medical practice. 

The whole world has changed considerably within the last couple of months, and the way healthcare is offered also changed with it. Now is the right time to focus all your attention on offering the quality care patients need while having a quality billing company working with you in order to deal with your billing and coding issues and needs.