Though telehealth medicine exists from ages, COVID-19 has given it a new look. With social distancing imparting in people’s life and made compulsory, it gave rise to tele-health medicine service to avoid the spread of the virus among patients. During the COVID-19 pandemic, the American Medical Association introduced many changes in medical billing and coding of telehealth medicine, which made practices, hospitals, clinics, DME billing and several other healthcare centres, struggle with billing. Let’s look back at the importance of telehealth billing services and what practices have to follow or change in the present scenario.
Importance of Telemedicine Billing
Telemedicine is considered a safe and effective healthcare delivery model, with payers and government gradually extending their coverage and payment in an effort to ensure public access to healthcare is made easy in a pandemic condition that the whole nation is experiencing. The more the safest treatment to patients and care, the more restrictions and limitations have been imposed on medicine and telehealth billing as well.
With constantly changing regulatory policies leading to lag behind advancements in technological potentiality, even telemedicine is not exceptional from it. Moreover, with drastic changes brought in the accessibility of telemedicine during the COVID-19 pandemic, huge impact is shown in reimbursements which are obstructed due to geographic restrictions, lack of payment parity, and a narrow approach in policy coverage.
For payers like Medicare or Medicaid’s convenience, AMA has excluded many areas that are outside a Metropolitan Statistical Area or in a Health Professional Shortage Area i.e. due to disability or lack of transportation.
Along with Medicare, several other commercial payers have applied for coverage restrictions on telehealth services in order to avoid potential concerns of overutilization, fraud, and low-quality patient care. Commercial coverage restrictions have come in both limitation of services and restriction to a wide range of network providers.
Commercial insurance payers have indirectly limited the access to telemedicine in the form of fee schedule. Before COVID-19, the norms for telemedicine did not expect a face-to-face consultation of patients with the physician. But it has been changed completely now and practices had to invest in the necessary technology to expand their own telehealth offerings to patients, which was actually a financial disincentive for practices.
Medicare’s regulations for telehealth billing and reimbursement are relatively stable nationwide though they are quite stringent, but the coverage for commercial and Medicaid telemedicine services across the Nation is decided by a variable patchwork of variant states and payer regulations. These consistent variations in coverage and payment policies can make your practice’s staffs confuse, commit mistakes in medical coding and billing, resulting in the loss of revenue.
The challenges faced by many practices to manage their telehealth billing cannot be overcome with limited and low-skilled staff. In order to stay updated to the changing regulations of payers, it is important to take guidance from an expert medical billing company. More than we look at benefits of telemedicine, it is also crucial to look at how challenging and important the telemedicine billing is. Simply providing tele-based treatment may not yield you revenue. We recommend you get in touch with 24/7 Medical Billing Services to ease out your telehealth medical billing and make your revenue stable.
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