The COVID-19 pandemic has exponentially expanded adoption of Telehealth prompting the population to progressively become accustomed to the convenience of virtual care. The skyrocketing volume of Telehealth visits as well as CMS extending various Telehealth PHE waivers and easing restrictions in PFS 2022 has encouraged providers and public/private payers to quickly embrace Telehealth. With the level of Telehealth service requirements and billing for services primarily based on medical decision-making and time, a technology-driven solution such as RevCDI-led coding from Reventics empowers physicians with continuous chart-specific feedback in near real-time for complete documentation of Telehealth encounters to ensure coding accuracy and optimize reimbursement.
Documenting Telehealth Services
Provider documentation plays an indispensable role in coding and reporting Telehealth services. With delivery of care based mostly on patient communication, all aspects of visit such as date of service, platform used, recordings of audio/video communication, diagnosis, treatment plan, etc., must be documented according to the latest guidelines.
Billing Telehealth Services
While Medicare covers a long list of eligible CPT codes, most private payers are billed for Telehealth Services using E&M CPT codes 99201-05, 99211-15 along with a GT or 95 modifier, indicating the services were delivered via Telecommunication.
Powered by digital technology, Telehealth has multiple tools in its arsenal for both patients and providers to augment patient care while making healthcare accessible to rural population as well as people with limited time, transport, and mobility. Telehealth provides access to medical specialists and improves coordination of care between patient and medical teams, while also supporting patients with self-management of their health. It is less time consuming for both patients and providers allowing more time for review of previous summaries, to thoroughly answer questions, review test results, refill prescriptions, schedule appointments, etc. Telehealth facilitates patients to consult with PCPs or seek alternative care before accessing ED services, thereby preventing low-acuity ED visit and overcrowding.
Telehealth helps to ensure appropriate post-hospitalization care and wellness through scheduled follow-up visits, routine monitoring, management of postoperative issues, etc., in a timely manner preventing unnecessary readmissions. It is convenient for maintenance-related visits, for instance, providers can virtually check-in on patients with chronic hypertension to ensure compliance with treatment plans as well as prescribe maintenance medications. Unlike curbside telephone consults, new-age Telehealth Services are delivered via the patient’s computer/smartphone as well as at originating sites, usually a physician’s office or hospital, with readily accessible telecommunication systems to enhance patient experience and care quality.
With more than half of the hospitals in the United States now conducting Telehealth Programs, Physician Practices are fast following suit, with multiple Regional Telehealth Resource Centers established to assist with implementation.
How Reventics Helps
Billing for Telehealth Services is tricky with reimbursement polices still forming, frequently changing, and varying from payer to payer. Providers can overcome these challenges by employing a technology-driven platform to accurately document precise data and maximize allowable reimbursement. RevCDI-led coding from Reventics focuses on all aspects of clinical documentation improvement and computer-assisted coding with continuous chart-specific feedback in near real-time to increase coding and billing accuracy optimizing revenue.