Many medical insurances, Medicare and Medicaid plan included, are now recognizing the need for Telehealth services. This is due to varying reasons including medical provider and patient convenience and even cost efficiencies for the medical insurance companies. Medical insurances are now paying for this service to accommodate both the medical practice and patient needs.
Why should I be billed for these services?
Providers are already taking calls on the phone from patients both on and off hours and now can get paid for these medical services easily. Basically, you may already be doing this work and now you can also be paid for it. This can even help medical providers expand their medical service delivery hours and medical service types while reducing costs. It also allows for patients in remote areas that don’t have locally needed medical specialists to have the access they may not otherwise get as well as to those who are too ill, too elderly, or disabled to travel. There is also a growing need for both psychiatry and psychology services in the market today, often referred to now as Teletherapy.
Medical Statistics:
Recent surveys have shown that over 64% of the population surveyed would be willing to have Telehealth visits with their medical doctor. Studies have also shown that Telehealth visits can reduce cost by over $100 per medical visit and that 83% of patient issues are resolved during the first Telehealth visit. More than 50% of doctors surveyed are willing to see patients using Telehealth. 78% of the emergency room, urgent care, and doctor’s visits can be handled safely and effectively over the phone. 74% of patients are comfortable with Telemedicine visits using technology instead of in-person medical visits. 76% of patients care more about access to medical care than the human connection. 67% of patients say it increases their satisfaction with medical care. 30% of patients already use mobile devices to check medical test results or other medical information. 21% of patients said not having to travel was the top benefit. 53% of patients said Telemedicine somewhat or significantly increased their participation in medical treatment decisions.
What is the difference between Telemedicine and Telehealth?
Telemedicine is the use of electronic technologies to improve the patient’s health by connecting the patient with a healthcare provider who is not in the same location. This visit may take place via phone calls, video chats or emails, on tablets, smartphones, and other wireless devices.
Telehealth is a broader term which may also involve a nurse, pharmacist, or any health professional. There is also mobile health, which is the use of the consumer grade wireless devices and cell phones used for telemedicine services for clinical care technology allowing for the greater provider and patient flexibility.
Related Article: Telemedicine – don’t do it based on wrong thinking
The terms Telemedicine and Telehealth are commonly used interchangeably. Telehealth in this article will encompass all health services and health providers, the use of which varies by state and payer.
To completely embrace the virtual world in healthcare you must identify the value of Telemedicine or Telehealth for your medical practice, your insurance companies, and to your patients.
Challenges include different payers having different compliance requirements which will take research into each insurance payer or insurance plan. Additionally, there are new computer systems to navigate, the latest medical billing rules, different medical insurance payer parameters, training, and tracking to keep up with. Commercial medical plans can be more easily handled depending on state regulations and insurance payer policies, and may even allow communication via popular platforms such as Skype or FaceTime. Also, certain prescription drugs require an in-person medical visit with the prescribing medical provider initially or periodically. Basically, each state is different and you need to know your own state regulations. Medicaid programs in 48 states and the District of Columbia currently allow Telehealth in some form. Some medical insurance plans pay a full fee for the service billed, others a reduced fee.
Read More: EHR Interoperability – Is it as difficult as it sounds?
Allowable medical providers include Physicians, Nurse practitioners (NPs), Physician Assistants (Pas), Nurse-midwives, Clinical nurse specialists (CNSs), Certified registered nurse anesthetists, Clinical psychologists (CPs), Clinical social workers (LCSWs), Registered dieticians, and Nutrition Professionals.
To bill for Telehealth effective as of January 1, 2017, use POS code 02 Telehealth with your standard CPT medical coding for services rendered. New for 2018 was that Telehealth medical billing modifier GT was eliminated for professional services, being replaced with POS 02 as providing an attestation of interactive audio-visual communication. Other plans use medical billing modifier 95 which denotes a telehealth system that provides two-way, real-time audiovisual conferencing between a patient and the medical provider. It is extremely important for compliance reasons that a medical billing modifier is used when indicated by the payer and to always maintain proper medical documentation. For additional information visit www.bymedicalbilling.com
This information included in this article has been obtained through resources provided by the American Academy of Professional Coders (AAPC).
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