Offshore Telehealth Billing Services Archives - InfoHub https://infohubservices.com/category/offshore-telehealth-billing-services/ Thu, 06 Oct 2022 14:31:52 +0000 en-US hourly 1 https://wordpress.org/?v=6.1.1 https://infohubservices.com/wp-content/uploads/2019/10/cropped-INFO-HUB--96x96.png Offshore Telehealth Billing Services Archives - InfoHub https://infohubservices.com/category/offshore-telehealth-billing-services/ 32 32 3 Essential ICD 10 Codes for Telehealth https://infohubservices.com/blog/3-essential-icd-10-codes-for-telehealth/ Thu, 06 Oct 2022 14:24:10 +0000 https://infohubservices.com/?p=47319 Be it any medical practice offering telehealth; one must adhere to the ICD 10 codes. There is no option for doctors, hospitals, or medical service providers to neglect such codes. In fact, they need to incorporate the telehealth strategy into their practice to stay in the competitive medical business.

However, there are also some challenges that telehealth facilitators are facing. It is because telehealth is a broad category and encompasses managing a wide range of complex situations. It ranges from remote monitoring of stroke patients to high-quality virtual convenience care and managing episodic, acute, and sometimes non-emergent conditions in fast, effective, and cost-efficient ways.

In such a scenario where the medical landscape of care is expanding worldwide, telehealth billing and coding must also be prioritized. Therefore, telehealth medical providers need to adhere to three core principles:

  • Implementation of the established care standards.
  • Ensuring insurance coverage.
  • Cross verification of the patient information.

The other vital aspect of telehealth billing and coding is understanding the ICD 10 codes and accurately implementing them as per the telehealth service provided.

What are the ICD 10 Codes in Telehealth?

International Classification of Diseases (ICD) codes are a set of designations used by healthcare providers to communicate diseases, symptoms, and findings of a patient’s diagnosis. ICD 10 codes are used to establish the medical necessity of the telehealth services to insurance providers for claiming the complete reimbursement.

While telehealth ICD 10 codes often appear on patient paperwork and bills, there are often instances when the codes are miswritten. The onus is on the telehealth service providers to ensure the correct codes are entered while necessary verbal or written consent is taken from the patient for any virtual consultation.

It must be remembered that the ICD 10 codes for telephone consultation differ from those used for video consultation and medical facility visits for the same condition suffered by the patients. 

Top 3 ICD 10 Codes for Telehealth

The release of the ICD 10 codes has now become a one-off manifesto for every healthcare professional and physician for recording and maintaining standardized clinical data, documentation, claims to process, and public health reports.

However, ICD 10 has many codes, and telehealth providers must be careful in identifying the correct code and entering it accordingly to ensure proper reimbursement of the claim. There are four primary areas that the telehealth coders must be aware of while implementing the codes:

  • Place of Service (POS)
  • Modifiers
  • Cost-Share Waiver
  • Cost-Share Coverage

Let’s have a look at the ICD 10 codes to be used for telehealth:

Evaluation Management Services on Telephone

The codes for E/M (Evaluation Management) services for telephone or audio-only has a different set of guidelines in ICD 10. In fact, the patient cannot be a part of a related E/M service that has originated in the last seven days or led to the same service in the next one day. The patient needs to be coded based on the duration of the E/M service or medical discussions as follows:

  1. 5 – 10 mins – Code 99441
  2. 11 – 20 mins – Code 99442
  3. 21 – 30 mins – Code 99443

Patients Monitored Remotely

The ICD 10 codes have also been valued by Medicare, where established and new patients can avail of remote monitoring for chronic, acute, and single disease conditions. A range of codes used under this category include:

  • 99091 for interpretation and collection of physiological data.
  • 99453 for educating the patient and set-up up the monitoring equipment.

There are five more codes under this category.

Emergency Department Telehealth Services

Under this category, dozens of codes range from 99217 for discharge services for observation care to G0406 – G0408, where telehealth consultation for inpatient follow-up is done in SNFs or hospitals.

It is vital to note that in telehealth Emergency Department services, the coding needs to be done for inpatient and observation. Also, a Modifier 95 is to be attached for commercial payers, and the Medicare telehealth billing may use it for an interim purpose.

Why Adhering to ICD 10 in Telehealth Billing is Important?

It is a known fact that when there is any incorrect coding in a bill, the reimbursement from the insurance companies will be either rejected or denied, which means there is a loss of revenue. With telehealth becoming a predominant way to get healthcare services for many, the ICD 10 codes must be adhered to to ensure that medical practices and practitioners get remuneration for their services.

But with new HIPPA codes, about 70,000 ICD 10 codes, and ever-changing health regulation policies and software, keeping up with them can be challenging for any practice. In such a scenario, Info Hub can help with the telehealth coding and billing process and ensure no revenue loss due to rejected claims. Contact their experts right now and understand the process regarding where to begin.

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5 Common Telehealth Billing Challenges https://infohubservices.com/blog/5-common-telehealth-billing-challenges/ Thu, 19 May 2022 13:07:53 +0000 https://infohubservices.com/?p=45856 Since the outbreak of COVID, the usage of telehealth services has exploded as a viable means of accessing and delivering care. From expanding the types of cases, to a rapidly growing number of digital devices that cover multiple patient care needs, the telehealth business continues to extend its range of solutions. However, as telehealth services have grown in popularity, new problems have evolved in the fields of licensing reimbursement, acceptance, EMR integration, and accessibility of health and awareness.

Lack of Paperwork Checking

Some of the most common reasons for telemedicine claim denials when charging insurance companies and government payers include:

  1. Insurance does not cover this service
  2. The person is not covered by the policy anymore
  3. The provider is not in the network
  4. A pre-authorization was necessary
  5. Incorrect information, such as the person’s name, ID number, or date of birth

In a clinic or office, these are all fairly simple denials to avoid because front office employees may check all of this data well before the patient visits. Patients are frequently asked to fill out or double-check personal information, copy new insurance cards, and complete insurance verifications over the phone or through computer systems. When dealing with telemedicine, providers risk having most of these checks undone. Instead, the patient could go to an online site and fill out their own information before being examined by a therapist. Typos, confusion about the information, and plain deception can all cause the payment to be delayed.

No Clarity on Coverage

One of the most significant obstacles to reimbursement in telemedicine is that payers have yet to catch up to the trend. Telemedicine visits are not covered by all commercial insurance plans, and Medicaid coverage varies by state. Providers must utilize the correct procedure code, a GT modifier to indicate that the service was provided via interactive video conference, and the correct service code location.

Because one of the benefits of telemedicine is that businesses, clinics, and hospitals may tap on the knowledge of doctors throughout the country, it may take some time to set up billing systems that can handle many states.

Absence of Sufficient Data for Care Continuity

A failure of platform integration might also cause care to be interrupted. If a patient is given telemedicine from one provider but switches to another for the next e-visit, the other physician may not have all of the information required to diagnose the patient’s illness. This of course creates confusion in the billing with incorrect information being fed in, and consequently failure of full reimbursement.

EMR

Integrating Electronic Medical Records (EMR) with telehealth technologies is typically expensive and time-consuming. Due to a lack of integration, double documentation is required, that is not only time intensive but also offers possibility for error and unhappiness among employees. To accomplish HIPAA compliance and ensure the security of sensitive data, the most highly secure exchange methods must be implemented. As telehealth expands, new systems of care must ensure that communication between physicians and patients is maintained or improved, relationships are strengthened, and healthcare effectiveness and efficiency are improved.

Reimbursement

One of the most significant telehealth issues has been CMS and commercial payers’ restricted reimbursement options and amounts, especially in comparison to conventional on-site consultations. Payment parity rules have been established in 28 states, however there is no enforcement mechanism in place. During the pandemic, the Centers for Medicaid and Medicare Services increased reimbursement, but the longevity of this temporary modification is unknown. It is reasonable to predict that advantages, insurance, and payment for Telehealth services will continue to expand as consumerism takes centre stage and proof of the advantages of telehealth services accumulates. CMS and other payers are expected to continue to make a growing number of claimable codes available.

The advantages of telehealth greatly outweigh the challenges of implementing the technology. Info Hub is built on enabling clinicians to overcome such obstacles and make easy, patient-centered care more accessible. We have a team of professionals ready to assist in developing a successful telehealth programme that puts you on the cutting edge of the healthcare industry’s future. Our reimbursement experts at Info Hub can assist clients with reimbursement process for telemedicine. Info Hub, a leading offshore medical billing company has a team of technical professionals available to assist clients with the implementation of partial or complete integration into their EMR systems, resulting in increased efficiencies and less work for our clients.

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