Telehealth Revenue Cycle Management in Medical Billing Services:

Apr 18

Since the COVID-19 outbreak in 2020, telehealth services have become a huge part of healthcare. This pandemic made a huge shift toward the remote world, forcing physicians and healthcare providers to continue their medical services remotely. This shift in healthcare brought various challenges associated with revenue cycle management (RCM).

For making any healthcare practice successful, the medical front office and billing play a critical part. This is why creating a perfect balance between providing safe patient care and correct medical billing is important. It is the only way to keep patients, healthcare providers, and the administrative body’s journey easier.

Challenges Faced by Telehealth Revenue Cycle Management:

With the shift in healthcare, several problems on the compliance end came to light. Some of the potential challenges faced by the revenue cycle management of telehealth services include

Insufficient patient medical history and documentation:

Complete documentation of the telehealth patients is one of the key components behind revenue cycle management. Before COVID-19, one of the major reasons behind telehealth’s insignificant traction was the lack of knowledge or medical history of the patients. This was because, with incomplete patient information and medical history, the healthcare providers couldn’t maximize their revenues. The reason; determining more critical or “hands-on-care” cases require complete information.

With proper documentation of the patient, healthcare physicians can evaluate the type of treatment and care the patient requires quicker! For this, healthcare providers can use EHR to:

Quickly access patient records
Schedule a remote or in-person appointment
Provide the necessary treatment and bill for the services rendered easily.

Successful medical billing also includes using an EHR that can work simultaneously with the healthcare practice’ RCM.

Medical transcription services are necessary for telehealth practices. It makes the whole process even faster and easier, allowing the healthcare physicians to focus more on providing safe patient care.

Less knowledge of the Telehealth Billing codes:

Before COVID-19, telehealth billing was limited, but CMS released new codes and guidelines for telehealth services during the pandemic. With the release of these new CPT codes for telehealth services came billing errors as healthcare providers weren’t familiar with the new codes.

However, these new adjustments ensured that patients could receive medical assistance along with maintaining safety for themselves and the physicians. The new codes also ensured that the physicians could get reimbursed for the services they performed. There are various factors to be considered and documented when coding a telehealth service:

Date of service
Platform
The notation of audio/video communication between healthcare physician and the patient
Findings based on patient communication
Treatment plan
Documenting the interaction as non-face-to-face (telephone or email interaction are considered as such)
Reporting or documenting whether the service was provided via:

Audio only
Using a secure patient portal

Medicare telehealth services have specific and unique newly updated codes. Based on the patient-physician relationship, correct HCPCS and CPT codes must be used to document the interaction.

Following are some of the newly added temporary CPT codes for telehealth services 2022 by CMS:

99441	telephone E/M service 5-10 min of medical discussion	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20
99442	telephone E/M service 11-20 min of medical discussion	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20
99443	telephone E/M service 21-30 min of medical discussion	Temporary Addition for the PHE for the COVID-19 Pandemic—Added 4/30/20

Errors in the patient information and paperwork:

Telehealth requires proper documentation and patient medical record for correct and focused medical billing. There are several reasons and errors behind claim denials and rejections when billing the payers. Some of them include:

Billing the services that aren’t covered by the Medicare
The eligibility criteria of the patient aren’t verified
Information like patient name, gender, date of birth, and ID number is incorrect.
Pre-authorization is required before billing the service.

The above-mentioned factors can be easily resolved or avoided with an administrative staff reviewing information and overseeing everything. This team of professionals asks the patients to double-check their data and provide updated insurance information. But with telehealth services, patients might be inputting their own information on the online portal. This can result in typos, misinformation, confusion about the information required, and factors like dishonesty, etc.

What is telehealth?

Telehealth includes providing medical services, information, or education via some digital or remote platform. Following are some of the technologies used for performing telehealth services:

Video or audio conference
Remote patient monitoring (RPM)
Mobile health apps
Store and forward

Telehealth medical services provide a variety of specialized medical care. It plays a vital role in monitoring and improving the already existing healthcare services. Following are some of the care options included in the telehealth services:

Post-surgical follow-up
Skin conditions
Online counseling
Therapy counseling sessions
Migraines
Issues like coughs, colds, stomach aches, etc.

What is Telehealth Revenue Cycle Management (RCM)?

For any healthcare practice, revenue cycle management is an integral part. Healthcare providers offer telehealth services to make medical care available to patients from a distance. But when it comes to medical billing and revenue cycle management, things can get a little complicated.

Outsourcing Telehealth Medical Billing Services:

Due to the COVID-19 pandemic, telehealth has become an essential part of healthcare practices. Revenue cycle management and medical billing are the two most integral parts of any healthcare practice. Medical billing is considered to be the backbone of the revenue cycle. Correct medical billing and coding results in lesser claim denials and faster payments, therefore, a higher reimbursement rate. There are several benefits of outsourcing telehealth medical billing services to a well-reputed medical billing company. Some of the benefits of outsourcing telehealth medical billing services include the following:

Correct medical billing
Reduced billing errors
Lesser claim denials and rejections
Higher reimbursement rate
Higher clean claim rate
Faster payments
Improved revenue cycle
Streamlined workflow
Reduced administrative tasks
More focus on safe patient care

UControl Billing is a results-oriented, medical billing outsourced services company. With UControl Billing, you get:

Competitive and affordable pricing
Increased reimbursements
Reduced overall expenses
Faster turnarounds
Increased cash flows
Eligibility verification
Fee schedule review and analysis
Claim tracking
Reduced claim rejections and denials