One of the most common questions Doctors have is how to bill Telemedicine through Health Insurance. A big question whether their insurance company is willing to reimburse the service at all.
Then there is the question of the actual process of being able to bill telemedicine through health insurance.
Here are four steps to help simplify the process to bill telemedicine through health insurance. This will encourage more of your patients to adopt telemedieince calls with you and skip over in-office visits.
1) Know your Telemedicine policies and billing codes
As of June 2016, there are 30 states allowing patients to bill Telemedicine through health insurance plans.
Specifically here are the CPT codes according to American Telemedicine Association that determine if Telemedicine is covered:
Code 98969 on-line internet assessment and management – non-physician,
Code 99444 on-line internet assessment and management – physician
Code 99091 collection and interpretation of physiologic data
Code 99090 analysis of clinical data stored in computers, without requiring an in-person office visit or other evaluation and management
Of course, the reimbursement value for telemedicine services is at the discretion of each insurance company. Gathering specific reimbursement values from each of your partnered insurance providers will help you know what your patients can claim and be reimbursed for.
Take half a day and call each of your insurance partners to ask the following questions:
- Does the policy allow/cover telemedicine services?
- How do you define telemedicine services? (video, text, audio, email)
- Which specific billing codes should be used?
- What if any restrictions are there around the service? (e.g. maximum uses per month, per year)
- Does the service require any special documentation from the doctor for coverage?
- What is the typical reimbursement time for patients?
- What (if any) are the typical reasons telemedicine services coverage are denied?
2) Verify the patients info before booking the appointment
Preparation can reduce patient confusion and misunderstanding. Many Telemedicine services, such as liveClinic, can bill the patient directly at a rate your choose, and then a reimbursement can be sent by the insurance provider.
A good suggestion is to offer telemedicine services only to patients of record to first determine if they are able to have the cost covered under their insurer.
3) File the Claim and Follow Up
As you integrate telemedicine into your clinic, there will be challenges. Virtual visits require technology and human understanding. If a patient chooses to visit with you via a remote Telemedicine service, they will need guidance and support on the next steps.
Make a calendar note to email the patient when their claim has been filed, and when the payment has been sent to them.
Think of companies such as amazon.com and how often they provide virtual follow ups letting you know the status of your order. Doing something similar for patients is key to smooth flow and the growth of telemedicine within your clinic.
4) Record the patients insurance coverage for future use
Having clear records of reimbursement history within your EHR system will allow patients to have a streamlined experience in future. Doctors offices who ask for the same information each time cause bottlenecks in their reception area, and when providing remote Telemedicine consultations, this practice is just not time effective.
Telemedicine is about convenience on both sides, and this requires having patient data available on file.
Making specific records about what Telemedicine services the patient has used before and what amount is reimbursed will help with future visits.
Following these steps will enable you to bill Telemedicine through Health Insurance. It will help you avoid confusion and denied or rejected claims.