Telemedicine refers to a category of services that are
provided to a patient without any actual
patient contact. Services are provided via a telephone, web portal or via email
interactions between the patient and provider.
The Corona virus crisis has created billing requirement with telemedicine a significant issue. The guidelines for billing telemedicine are not only changing apace but also differ from payer to payer. All the major private insurances pay telemedicine. Private insurance companies and Medicare are streamlining telemedicine policies virtually on a daily basis. Now Medicare allows telemedicine visits for new patients as well.
Simple pointers to consider when billing telemedicine:-
• Confirm that the patient’s insurance covers telemedicine. Always call and verify coverage with the patient’s insurance before their initial telemedicine visit
• Knowledge of the telemedicine guidelines for each payer. Rules and regulations differ from payer to payer and also area vice.
• Claims for covered telehealth services provided at the distant site need to be submitted using the applicable CPT or HCPCS code.
Documentation necessities for a telemedicine service are the similar as for face-to-face services. As telemedicine becomes more efficient and improves patient outcomes, more services are likely to be approved for reimbursement. In the present situation as more payers reimburse telehealth services, payment policies and criteria will be regularly amended, hence constant observation and updation is required on the telemedicine billing services.
Medical Credentialing consists of verifying the qualifications of licensed medical practitioners and assessing their background and legitimacy. Credentials are documented evidence of license, education, training, experience, or other qualifications.
Not obtaining proper credentialing can lead to lost revenues. This results to loss in medical bills for various services provided by the uncredentialed professionals. Medical credentialing process also validate a medical provider’s regulatory compliance record and malpractice history before allowing that provider to participate in a network or treat patients at a hospital or medical facility.
Medical credentialing is a vital part of the Medical Billing process without which it cannot even be completed.
Steps to follow for efficient Medical Credentialing process:
- Confirm all documents are up to date
- Provide adequate references
- Begin early and pay attention to details
- Have knowledge about the State’s Credentialing specifications.
An efficient workflow will help overcome medical credentialing problems and thus avoid money loss in handling appeals and reimbursements. SpectraMedi Medical Service Organisation provides simple and cost effective Credentialing service. Our service help Providers handle the burdensome procedures of enrollment and credentialing at a competitive price.
is a catastrophic plan?
to have low premiums but still protect its enrollee’s from
substantial medical debt if they suffer a catastrophic illness. These
plans have a major role in Covid-19 crisis.
In medical billing, diagnosis and treatment of COVID-19 can be filed under catastrophic plans. These plans must cover essential health benefits (EHB) as required by the Patient Protection and Affordable Care Act (PPACA) but are typically subject to limitations. Health issuer can amend their catastrophic plans to provide pre-deductible coverage for services related to the diagnosis and treatment of COVID-19.
plans help patients who can’t afford more comprehensive plans.
Though expanded catastrophic
plan maybe harder
on medical billing systems, reimbursements to hospitals and providers
will likely remain the same.
Robotic Process automation (RPA) with its cost savings, speed and efficiency is slowly making its way into all industries and all types of business processes. Enterprises and service providers are adopting more tools that aid automation. RPA enhances accuracy.
Robotic Process Automation (RPA) has the perfect solution to transform revenue cycle management. It unites an organization’s systems, including electronic health records, billing, patient payment portals, and credit card processing applications. Automation in data entry and insurance claim processing results in fast and precise process completion.
Robots connect to the payer website, handle insurance aging and resubmit claims without human intervention – saving significant time and resources.RPA can help medical billing organizations when processing information as physician credentialing and enrollment as well as checking patient eligibility.
RPA is complementary to existing systems and processes, enabling health care organizations to address gaps in existing processes. Additionally, it creates a 24/7 work force which is more efficient and quicker resulting in improved collections.