2. Billing Guidelines for Tele-Health Clinics
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Out of numerous changes in the healthcare industry, CMS has added
another one by including Tele-Health services in the Medicare Payment
Protocol as part of the healthcare emergency services during the
COVID-19 pandemic.
As a result, Tele-Health clinics and healthcare providers have been
facing a few challenges. And, the biggest concern is relating to the
accurate Tele-Health billing and coding to get no or less denials.
Moreover, it adds on more immense problems for the practices to stay
afloat especially when Tele-Health clinics are struggling with the
telemedicine services. Hence, it is essential to know how to code and bill
the telemedicine services accurately.
But have you ever analysed the reasons for such challenges?
The challenges faced by the Tele-Health clinics are arising usually due
to the drastic changes occurring in the Tele-Health policies. It is
combined with the staff lacking the experience in keeping up to date with
these changes and documentation.
Read more…
3. Billing Guidelines for Tele-Health Clinics
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
1. Know the Codes for Billing in Tele-Health Services
CMS has approved a list of correct codes for billing the Tele-Health
services. They are:
G2010 for evaluating the patients' images or videos that do not originate
from or lead to an E/M service.
G2012 is used for virtual check-in or other communication with the
healthcare provider using some technology.
G2061 – G2063 is established for services like assessment and
management provided by a professional healthcare qualified non-
physician online.
99421-99423 offers an online evaluation and management service to an
established patient for seven days.
99441-99443 is to be used when Tele-Health services are provided only
via telephone.
4. Billing Guidelines for Tele-Health Clinics
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2. Selecting the Right POS and Modifier
There has been a change in the CMS interim final rule where the coders
during the PHE should not use the POS 02 Tele-Health. Instead of using
the CMS-1500 form, the coders must enlist POS, which would be used
when there is no PHE.
For example, the coder is to use POS 11 if the beneficiary was seen at
the clinic by the provider.
According to the CMS, the correct modifiers for the Tele-Health billing
amends are:
95 – Use of audio and video technology to provide Tele-Health service
G0 – In case of symptoms of acute stroke, there is the diagnosis,
evaluation, and treatment with a Tele-Health service
GT – Interactive audio/visual technology is used to offer telemedicine
services
GQ – Services in telemedicine are provided through an asynchronous
telecommunication system.
5. Billing Guidelines for Tele-Health Clinics
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3. Correct Documentation for Reimbursements
One of the reasons Tele-Health clinics find themselves in loss of revenue
is inaccurate and incomplete documentation.
Several factors are in play when it comes to correct coding and
documentation for the reimbursement of the services. For instance, the
codes differ in the audio and visual telecommunication tools used during
the service. Also, the provider's diagnosis, findings, and treatment can
change the coding of the service.
Any video consultation that offers a face-to-face visit with the clinic must
include the billing document apart from the codes, the platform used,
and the date. Likewise, any patient consulting and getting service via
telephone, email, or other audio tools must be categorized into non-face-
to-face services. It should also mention the platform through which such
service was provided, like whether it was on a patient portal or only
audio communication along with the date.
6. Billing Guidelines for Tele-Health Clinics
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
Conclusion
To ensure all these guidelines are followed correctly, the Tele-Health
clinics should outsource their medical billing services to a Tele-Health
billing and coding company. An experienced medical billing company
can conduct periodic and focused audits to warrant the clinic about filing
its documentation correctly and compliant with the Medicare Tele-Health
revised guidelines.
Also, sometimes it is best to find additional guidance of expert billers and
coders with updated knowledge of Tele-Health billing rules and codes
upcoming in the healthcare industry. They can help you to select the
right POS and modifiers while filling the claims to ensure complete
reimbursement and higher revenues. Therefore, the best way to ensure
efficiency with the coding and documentation while keeping up with the
revised Tele-Health guidelines is by outsourcing Tele-Health coding
and billing system to a knowledgeable partner like 24/7 Medical Billing
Services.
7. Billing Guidelines for Tele-Health Clinics
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
About Us:
We are a medical billing company that offers ‘24/7 Medical Billing
Services’ and support physicians, hospitals, medical institutions and
group practices with our end to end medical billing solutions. We help
you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow
physicians to attract additional revenue and reduce administrative
burden or losses.
8. Billing Guidelines for Tele-Health Clinics
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Media Contact:
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