Remote healthcare is possible only with frameworks like telehealth, which allow patients to access care via telecommunication technologies. Telehealth services provide convenience and enhance accessibility to patients, allowing management of chronic diseases.
While this scheme is important for making medical services available to patients, telehealth billing is vital for healthcare practices. Understanding the nuances and navigating through the complexities of telehealth billing becomes essential.
Not all healthcare providers are familiar with this concept. They may struggle to get adequate revenue and improve their workflow while billing for telehealth services.
If you are one of them, this blog is for you. In this blog, we will discuss everything about this framework and recognize the changing trends in telehealth so that you can maximize your revenue.
Introduction of Telehealth Services
Telehealth is nothing but a system of rendering remote healthcare services with the use of technology. Patients can access medical assistance via face-to-face online meetings, remote patient monitoring, and mobile applications.
After the pandemic, the scope of telehealth was widened, making it a preferred medium of accessing healthcare.
Why Do We Need Telehealth Services as a Society?
- After the pandemic, it is clear that not everyone can reach medical facilities. However, telehealth services offer accessibility and convenience to patients. Patients can get medical assistance from anywhere irrespective of their geographical location.
- Telehealth reduces the need to visit the healthcare provider along with the cost of traveling to the healthcare facility. Due to this, the framework reduces the overhead expenses and becomes cost-effective.
- More patients choose telehealth for chronic disease management as they can get medical assistance on a shorter notice as compared to visiting the facility in person. This enhances patient engagement.
Telehealth Services and Telehealth Billing
Telehealth proves to be beneficial for the patients and healthcare providers. While patients get seamless access to healthcare services, healthcare providers get a chance to elevate their revenue cycle.
However, with benefits come the challenges!
Telehealth billing is complex and handling it without proper skill can be a hassle for healthcare providers and practices. That is why healthcare providers must understand the scope of this framework and perform its billing appropriately.
Healthcare providers and practices must know the complexities of telehealth billing and take corrective action to maximize revenue.
Everything About Telehealth Billing
Seeking healthcare services in person is very different from seeking medical assistance via telecommunication. This is the reason behind the complexities of telehealth billing. If you want to improve your administrative process, then understanding the given points is a must:
Documentation and Medical Coding
Documentation is a significant part of medical billing and so is for telehealth services. When it comes to medical coding for telehealth, there are specific requirements to ensure accuracy and efficiency. There are some unique codes of telehealth developed by The Centers for Medicare and Medicaid Services (CMS). Both documentation of rendered services and their accurate coding are essential to ensure a smooth medical billing process with a reduction in claim denials.
Compliance with Regulatory Standards
Telehealth billing is dynamic and subject to frequent regulatory changes. In some conditions certain medical services can be relaxed for revenue, and in other conditions this rule can be reversed. For example, during the pandemic, several medical services were allowed for reimbursement under the guidelines of CMS. That is why healthcare providers must stay current with changing regulatory requirements and adhere to necessary compliance standards for adequate revenue.
How to Improve Telehealth Billing?
If you want to improve your telehealth billing, then follow the points given:
Training Your Medical Billing Staff
In case you have an in-house medical billing staff, you must focus on training and educating your staff. This must involve knowledge of specific CPT and ICD codes along with other major telehealth billing requirements.
However, if you operate the administrative process yourself, then you must be familiar with all these requirements yourself. One more method to simplify this is outsourcing telehealth billing from medical billing experts.
Integration of Technology
Efficient telehealth billing depends on integration with the electronic health record (EHR). This is necessary to ensure accurate billing and coding. This plays a huge role in accurate recording of patient medical records and capturing the same for effective coding. This is also vital to make sure that operational flow is smooth, and revenue flow is boosted.
Seamless Communication with Patients
Since all the communication between a patient and a healthcare provider is via digital channels, making sure that the patients understand the terms of billing is crucial. It is your duty to introduce patients to concepts like out-of-pocket costs and insurance coverage. This will reduce insurance coverage-related confusions and enhance reimbursement. On the other hand, when there is transparency, patients feel more connected with the services, and this leads to patient satisfaction.
Supervising the Telehealth Billing
Monitoring your telehealth billing process to identify shortcomings and taking corrective action is also fundamental to efficient revenue cycle management. So, you must stay proactive and find out drawbacks in your billing process for initiating measures to improve your current telehealth billing process.
Understand the Drawbacks and Take Measures to Avoid Them!
The journey to maximize your revenue and uplift operational flow starts with understanding the drawbacks and taking measures to improve the situation.
Here are some major reasons behind faulty telehealth billing:
Improper Coding and Documentation
Improper coding and documentation are two of the major reasons behind denials and revenue leakages. You must fulfill the specific coding requirements to ensure a reduction in claim denials and compliance drawbacks.
To achieve this, you need to stay informed with the latest coding trends, utilize technology to minimize manual errors, and carry out regular training and auditing. This way healthcare providers can elevate their telehealth billing.
Need to Comply with Regulations
Telehealth services are emerging, introducing the scope of frequently changing regulations and compliance standards. You must stay updated with regulatory requirements and compliance programs under CMS. Managing all this on your own can be a challenge; that is why you can partner with experts and optimize your telehealth billing.
Communication Breakdown with Patients
If you fail to establish clear communication with your patients, then you are setting up for confusion and dissatisfaction. This is not an ideal situation for implementing an effective administrative process.
You must follow transparency and develop effective communication with patients. You can do this by creating patient portals for solving patient issues and offering consistent customer support.
Fluctuations in Reimbursement Rates
Reimbursement rates vary for telehealth services, and the standards are set by insurance providers. Sometimes, dealing with such standards may be a challenge for healthcare providers.
You must realize the importance of payer contract review and make a streamlined billing strategy to ensure submission of claims with accuracy and on time.
EHR System Integration Difficulties
Telehealth services work best when paired with EHR systems. However, EHR integration is not seamless; it can create issues as well. It can also lead to incomplete information and inaccurate telehealth billing.
To counter this, you must prioritize the implementation of integration solutions. This can be done by engaging in IT support with systematic planning and execution.
Bottom Line
Telehealth services and telehealth billing are both new for healthcare providers. They are still figuring out the most appropriate course of action. Medical billing services understand the complexities of telehealth and offer solutions just for them.
If you are struggling to keep up your revenue, then Eminence RCM can help you!
Eminence RCM is a medical billing company offering effective telehealth billing solutions to healthcare providers and practices. Our team unites its efforts to fulfill your unique telehealth billing requirements. We ensure an efficient and accurate medical billing process to maximize your revenue and optimize the workflow. Our team stays HIPAA compliant and uses technological tools to ensure the overall upliftment of your healthcare practice.
Choose Eminence RCM and lead your healthcare practice to better revenue cycle management!
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