The advantageous use of technology to successfully treat and manage patients in a world that restricts physical consults to prevent the spread of the virus has served both patients and physicians.
However, as explained in this article, telehealth’s quick implementation hasn’t allowed much time for medical practices to catch up with all the requirements for payment and billing from Medicare and other payers. Just like Covid-19, telehealth is relatively new territory for the medical community. Therefore, physicians should be mindful of the possibility of future audits and take measures to ensure proper documentation of telehealth encounters as outlined in this article we read.
The author explains that healthcare providers have little experience with claims denials for the recently expanded telehealth services and this has led them to be detailed in their documentation. To decrease the likelihood of claim denial, providers need to document “date, time and place of service, length of the conversation, emergency room or outpatient consultations, provider recommendations, and follow-up visits.”
Also, the technological vehicle used to do the consultation, whether audio and/or video, and the patient’s consent to use apps that don’t have privacy protection, such as Skype, needs to be specified in the progress note.
The article also contains some good practices for telehealth reimbursement compliance: continuously monitoring and auditing telehealth claims, staying current on government and private payers’ developing guidelines, redirecting employees’ efforts to ensure billing compliance, and training coders.
Telehealth services are likely to be around for the long run. As medical practices continue to send claims to their payers, guidelines will be perfected to generate proper reimbursement based on medical necessity and the complexity of the physician-patient encounter.