Mastering Telehealth During the Pandemic

Trying to keep your patients and staff safe and maintain practice income is a juggling act! With a decrease in face-to-face visits, you will want to ensure you are conducting, documenting and billing telehealth visits accurately. Every insurance seems to have different guidelines as to which place of service code or modifier to use. Need some help getting it right? Here are some tips:

• Many national insurers, including Medicare, do not have an end date for their allowance of telehealth; they simply say the expanded benefits are in place until the pandemic is declared over. However, some insurances have published end dates that keep changing! Visit each payer's website regularly to check for updates regarding end dates so you're not surprising your patients with bills due to terminated telemedicine coverage.

• Some insurers want the place of service to be "02" and others want whatever place of service code you would normally use (i.e. 11, 22, 32, etc). Some payers want the modifier "GT" and others want "95". Make sure your billing staff is reviewing the billing guidelines published on each payer's website regularly as rules are subject to, and often do, change.

• Many insurances began processing telehealth claims before their editing software was ready. This resulted in numerous claims being paid at incorrect rates, or balances being put to the patient responsibility incorrectly. It is important for your billing staff to review remittances regularly and follow up on claims that are not paid accurately.

Staying on top of the rules and regulations regarding telehealth will ensure your practice maintains the necessary income to be successful. Need more guidance or assistance? Premier Medical Billing LLC is available to answer your questions. Contact us today!

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