A Brief Guide to Telemedicine Billing

Telemedicine, formerly a cutting-edge method of medical care, has quickly evolved into a viable choice for many healthcare practitioners today. According to a recent AMA research, telehealth usage is rising at a faster rate than any other sort of medical care solution, with a 53 percent total increase.

Furthermore, the current COVID-19 pandemic necessitated a rapid shift in priorities for a huge number of healthcare institutions, including major players like Medicare and Medicaid, which now cover a wider range of telehealth services.

Integrating Medical Billing with Telemedicine

The medical billing software that is capable of customizing both billing and coding procedures can help healthcare businesses eliminate errors, increase profitability, and speed up claim payouts. The following are some of the primary advantages of integrating medical billing software with your telemedicine platform:

Time Savings

Patients can pre-register with medical billing software in place, which saves time. Because all new patients you onboard complete intake forms and supply insurance-related information even before their first consultation, this saves you a lot of time. Following this approach also saves a significant amount of time for both the patient and you.

Streamlined Workflows

Medical billing software allows you to send a claim to another party right away. It also enables the healthcare provider to post outlays at the point of care, which speeds up the filing process. The electronic tracking feature that comes with medical billing software allows your financial team to update the cash flow management activity from time to time, in addition to speeding up the electronic claim process.

Aside from the ones listed above, there are a slew of other advantages that your clinic can gain by implementing medical billing software. It has the potential to elevate your telemedicine care delivery experience to new heights.

Common Telemedicine Billing Codes

In the United States, medical practitioners employ a single set of telehealth billing codes to help payers, providers, patients, and patients determine coverage and the medical necessity of the service. The CPT Editorial Panel of the American Medical Association produced this list, which is known as the Current Procedural Terminology.

These CPT codes, when combined with the International Classification of Diseases, or ICD, codes, create a database of probable services provided by the practitioner in accordance with the ICD’s diagnoses. The billing department can bill the payer via a clearinghouse or directly after each telehealth encounter or treatment obtains a code. In the majority of circumstances, this entails sending an ANSI 837 file via EDI.

Completing the Telemedicine Billing Process

Once the payer receives the billed claims, a medical claims adjuster will assess whether the claim is approved, denied, or rejected based on the necessity of the treatment and the patient’s coverage eligibility. When a claim is authorized, the insurance company reimburses you at a pre-determined rate.

Failed and denied claims are returned to the provider with an explanation of benefits (EOB), who must then correct the claim and resubmit it. This process may repeat itself until the payer agrees to pay the required reimbursement or the provider agrees to accept a partial payment.

Most refused telehealth claims are due to a lack of attention to the originating site, remote site, and codes approved by payers such as Medicare and Medicaid, which both place severe restrictions on the grounds for telehealth operations. Unfortunately, each year, these denials cost you 3.3 percent of your overall revenue.

Too Complicated? Start Outsourcing Telemedicine Billing Services today!

If you’re one of the many doctors who has added telehealth to their list of services, you may be facing more medical billing ambiguity than ever before. Consider employing an experienced medical billing company instead of taking on the burden of training, reacting to regular payer regulation changes, and paying your own coding and billing personnel. While you focus on your patients, a third-party team can handle the complexities of your telehealth billing.

The benefits are many

Experienced medical coding companies and billing professionals with a focus on telehealth standards for Medicare, Medicaid, and major insurance carriers work for telehealth billing companies. A third-party company can focus on continual training and certifications to maintain its employees current and competent.

Outsourcing your telehealth billing allows you to pay less for expertise than if you staff your own billing department. Better yet, you won’t have to incur the additional overhead expenditures that come with adding a new employee to your business, allowing you to increase your revenue potential even more. Claims can be submitted in hours rather than days when you have a skilled crew at your disposal.

It’s critical to assemble the best staff to handle this critical area of your practice. You’ll need a medical coding¬†business that uses top-of-the-line EHR software, provides ongoing training and resources, is transparent in its collection and claims procedures, and has a thorough understanding of the industry’s evolving landscape. Perhaps more essential, you’ll require a medical billing business that is equally committed to increasing your revenue as you are.

With KIWI-TEK, you’ll get all of that and more! Make an appointment or speak with one of our knowledgeable agents today to take advantage of our complete medical coding services.