What is Telemedicine?
Telemedicine are medical services provided via telephone, the Internet, or other communications networks or devices that do not involve direct, in-person patient contact.
How could you bill Telemedicine?
Telemedicine is a hot topic in healthcare, with consumers more willing than ever to see a doctor remotely. The most common questions doctors have is how to bill Telemedicine through Health Insurance. As a relatively new care method for the wider patient population, the guidelines for billing telemedicine are still forming. In fact, the rules for billing telemedicine can often vary from payer to payer (Medicare, Medicaid, Private payer.
Then there is the question of the actual process of being able to bill telemedicine through health insurance. Hopefully, we’ll soon get the point where there are clear guidelines for billing telemedicine across all payers.
Do you have more telemedicine billing questions? Feel free to email us at support@wonderws.com and we’ll try our best to help you out.
Physicians today can feel positive about bringing this powerful tool into their practices as telemedicine continues to receive increased levels of reimbursement. Here are the top things you should know when billing telemedicine through Health Insurance:
- Know your Telemedicine billing codes and policies: There are 30 states allowing patients to bill Telemedicine through health insurance plans. We’ve found that most payers advise providers billing telemedicine to use the appropriate evaluative and management CPT code (99201 – 05, 99211-15) along with a GT modifier (more on that below).
- Verify patient’s insurance covers telemedicine beforehand: The Preparation can reduce patient confusion and misunderstanding. The best way to ensure you can bill and get paid for telemedicine is to call and verify coverage with the patient’s insurance before their first telemedicine visit. A good suggestion is to offer telemedicine services only to patients of record to first determine if they are able to have the cost covered under their insurer.
- Do followup and file the Claim: Virtual visits require technology and human understanding. If a patient chooses to visit with you via a remote Telemedicine service, they will need guidance and support on the next steps. As you integrate telemedicine into your clinic, there will be challenges. Doing something similar for patients is key to smooth flow and the growth of telemedicine within your clinic.
The reimbursement value for telemedicine services is at the discretion of each insurance company. Gathering specific reimbursement values from each of your partnered insurance providers will help you know what your patients can claim and be reimbursed for. I have found the easiest way to learn what each payer wants for telemedicine is just to call and ask the right questions.
Here are some of the things you should ask:
- Which healthcare providers can bill for telemedicine?
- Does the policy allow/cover telemedicine services?
- Do you specifically cover live video telemedicine?
- What if any restrictions are there around the service?
- Are there any restrictions or conditions that need to be met before a patient qualifies for telemedicine?
- What is the typical reimbursement time for patients?
“Telemedicine has huge potential to improve access to quality care and decrease costs, and to make healthcare encounters more convenient and satisfying for providers and patients. Understanding how and when providers are reimbursed for delivering healthcare through telemedicine can be challenging, but not impossible. Breaking it down by each type of payer makes it easier for providers to gain clarity and make informed decisions about telemedicine.”
Are you ready to start billing telemedicine? Hopefully this gave you the basics you need to get started.