You hear it everywhere "Telehealth is here to stay". But as a healthcare information management professional, how does this phrase make you feel about the future of your healthcare organization? Are you and/or your team struggling to embrace new telehealth regulations appropriately and quickly enough to stay afloat?
In our latest webinar, “Telehealth is here to stay: The Key To Long-Term Success In Revenue Cycle” we discussed the key practices that need to take place in order to confidently forecast a long-term investment in telehealth.
Our speakers, Marie Thomas (VP of Revenue Cycle Operations), Evelyn Santos (Coding & Auditing Specialist), Kara Carlsile (Coding & Auditing Specialist), and, Dorothy Lodato (Billing Expert) shared what it takes to stablize your revenue cycle enough to run its course smoothly.
Read this recap article to learn the important highlights of the webinar and the best practices in telehealth revenue cycle management.
The Difference Between Telehealth & Telemedicine
We started the discussion by establishing the primary difference between telehealth and telemedicine. The words telehealth and telemedicine are sometimes used interchangeably. But telehealth involves a broader set of technologies pertaining to the healthcare industry.
While telemedicine refers to only remote clinical services, telehealth, on the other hand, can also refer to remote non clinical services.
The Telehealth Market is Booming
There has been a tremendous increase in the utilization of telemedicine over the past few years.
- The number of patient visits across the US in telemedicine grew from 350,000 visits in 2013 to 800,000 visits in 2015 to 7 million visits in 20181
- The global telemedicine market was valued at just $17.8 billion in 2014. However, by 2020, it is estimated to reach $185.6 billion in 20261
- The patient adoption of telehealth boomed from just 33% in January 2020 to 71% in June 20201
Why Telehealth is Here to Stay
There are 4 notable factors that are driving the adoption of telehealth among patients and providers:
- Convenience: Telehealth provides services to patients simple and worry-free
- Increased Access: Decrease in “no shows” and/or “canceled visits”
- Flexibility: Patients can now choose an in-person or telehealth visit via a phone, computer, tablet or even a cable device attached to their TV
- Revenue: Telehealth acts an alternative source of revenue for organizational financial loss if/when optimal reimbursement is captured correctly
Telehealth & Revenue Cycle Management
1. The Front End: Billing
Below are a few billing tips to help reduce or mitigate denials from telehealth:
- Once the appointment is scheduled verify:
- Patient’s insurance
- If their policy covers telehealth services and limits
- What services and rendering providers are covered
- Once a patient is confirmed, make sure a message is sent to the patient instructing them how to check in for their e-visit
- Ensure patients sign or verbally agree via a recorded session for telehealth visit
- Patient’s family or caretakers can join visits to ensure proper communication regarding
- the care of the patient. However this must be documented in the chart.
2. Middle: Documentation
Proper documentation is essential for coding, billing and receiving appropriate reimbursement. It’s recommended to follow the same documentation guidelines/templates as face-to-face visits.
Documentation must include:
- Whether the telemedicine visit video and audio or just audio
- Reason for the visit
- Who provided the service
- Place of service
3. The Back End: Billing Process
Once the the provider has signed off on the chart, here are three actions you can consider for a seamless billing process:
- Biller will scrub claims to review patient information and services rendered
- Verify if carriers require certain guidelines or information on claim form
- Ensure a clean claim is submitted for processing by the biller
Case studies: Telemedicine Coding
In order to make the webinar more interactive, we presented two case studies on telemedicine coding and asked participants to vote for the right ICD-10-CM and Professional Service codes in each case. You can read these case studies in the webinar handouts. Check out the on-demand version of the webinar to access the handouts!
It takes timeliness and a collaborative teamwork to obtain revenue cycle success. The telehealth experience has taught all of us that we have to work collaboratively together. Whether it's a coder CDI, billers, auditors, we have to work together to deliver the best results.
Finally, we wrapped up the session by answering some important FAQs around the topic!
Choose the Right Partner for Telehealth Coding and Billing
ECLAT Health Solutions has extensive experience in telehealth coding and billing as well as the knowledge to work with you and your payer for proper reimbursement of Telehealth services rendered. Partner with our dynamic team of accredited AAPC and AHIMA coding professionals and experienced billing experts, to overcome common telehealth challenges like appropriate use of modifiers, establishing medical necessity and determining the correct place of service.
Click the below link to set up a virtual consultation and learn our flexible outsourcing options amid COVID-19.
1Zimiles, A. (2020, July. Four new statistics that prove that telemedicine isn't just a pandemic fad. Retrieved September 16, 2020, from https://www.medicaleconomics.com/view/four-new-statistics-that-prove-that-telemedicine-isn-t-just-apandemic-fad