Telehealth is quickly growing as more providers adapt to new technology and opportunities, but there have been barriers to adoption. I’ve seen some organizations hesitant to invest in telehealth services, despite the growing need, because of uncertainty surrounding reimbursements.
It is a problem that we must address quickly, because patients like the convenience and access telehealth affords. Many may have felt they were pushed into telehealth during the start of the COVID-19 pandemic, but patients have seen the ease and speed in which they can receive care. According to an American Medical Association report, 62% of patients feel they have a higher satisfaction due to telehealth.
Better understanding the concerns and opportunity around telehealth building will go a long way for shoring up the long-term sustainability of telehealth programs.
Previously, I wrote an article about Reimbursement Tips: Getting the Most from Locums Work. Now we’re diving into telehealth to expand on a topic that many hospitals struggle with. Here are 4 Billings Tips to Get the Most from Your Telehealth Services.
Understand the difference between Originating and Distant Sites
When looking at telehealth billing, there is a necessary distinction between where the service is provided. Hospitals and Medical Office Practices must note whether it is:
Originating Site –Originating site refers to telehealth services that are rendered inside a medical facility, for instance a medical office, hospital or long-term care facility.
Distant Site—Distant site refers to services received outside of a medical facility, for instance a telehealth appointment from home.
Telehealth services are reimbursed at different rates based on where care is delivered. CMS reimburses at a higher rate when telehealth is delivered at an Originating Site (ie. a physician office). It is important to submit the current telehealth services claims to ensure you are properly reimbursed.
It is important to note that an originating site must be located within the continental US, Hawaii, Washington, D.C., or any United States territory (i.e. Puerto Rico) in order to be able to bill for services rendered.
Ask insurance payors about additional requirements for telehealth enrollment
Insurance payors may have additional requirements for information when it comes to telehealth. Ensure that you meet all requirements for telehealth enrollment. In many cases, there may be a specific telehealth enrollment application.
A few clarifying guidelines that payors may have regarding telehealth:
- Which Healthcare providers can bill for telehealth serves
- What Healthcare services can be delivered via telehealth
- Conditions to be met before a patient qualifies Telehealth, for instance an established provider-patient relationship, etc.
By making sure these criteria are met ahead of billing, providers can ensure they are reimbursed faster for their services.
Push for higher levels of reimbursement from CMS and payors through lobbying efforts
There are still barriers to increase the adoption of telehealth to other service lines and locations. Hospitals and medical practices often blame poor reimbursements for their inability to invest in and expand telehealth services. It is important that the healthcare industry make changes to properly reimburse telehealth services for the value they bring to patients and communities. Telehealth services play an important role in increasing access and delivering healthcare to growing populations. Through lobbying and other external communication initiatives, healthcare organizations should push for proper reimbursement practices that demonstrate the value telehealth brings to the industry.
Work with an expert to maximize your billing processes to ensure there are no gaps
Reimbursements can be complicated. My job is to help healthcare organizations maximize their reimbursements by optimizing their processes whether delivering care in-person or virtually. I’ve seen it all and created roadmaps that can help organizations maximize their earning potential. It’s an invaluable tool that more organizations should take advantage of because it can have a large impact on the bottom line.
If you’d like more information on how LocumTenens.com can help with your billing questions, please reach out to us at the below link or call LT Telehealth at (800) 662-8663.
About the author
Matt Littlejohn
Senior Provider Enrollment Specialist
Matt Littlejohn is a Senior Provider Enrollment Specialist at LocumTenens.com who simplifies enrollment for clients, shows them the true value of proper enrollment, and helps them realize it's not as difficult as they think. Matt has been with LocumTenens.com for 4 years. He developed his passion for enrollment while working at a large physician practice and seeing the impact it can have on the operational sustainability of an organization. Matt graduated from the University of Georgia.
