With the active and ongoing COVID-19 pandemic, healthcare providers and support platforms are finding innovative ways to minimize risk. Most medical offices are working hard to minimize the number of patients they see in person because they don’t want to expose non-infected patients to the virus.
This has led to some new developments in how The Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) are providing and paying for telehealth services. Here are some of the most important changes you need to be aware of:
Telehealth Reimbursement and Revisions
Effective March 6, 2020, CMS expanded the telehealth benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act.
If you’re a physician or any other healthcare provider, this means that Medicare will pay for office and hospital visits as well as other types of treatments that you provide via telehealth services. Before the COVID-19 crisis, only senior citizens living in rural areas and seen at select certified sites were able to get coverage this way. Unless otherwise stated, you can now apply these codes to any new patients or existing patients under the 1135 waiver.
Identifying Telehealth Treatments
It’s important that your telehealth treatments meet the definition of what’s covered. Telehealth and telemedicine services are virtual healthcare visits. During these sessions, a physician and patient will meet through digital and electronic platforms that may be video or audio-driven. They will exchange medical information and discuss treatment. This type of visit allows patients to access the resources and medical help they need without actually going into a doctor’s office physically.
Physicians are expected to treat telehealth treatments in the same way they would treat a typical in person office visit. Telehealth services can also be delivered by a nurse practitioner, clinical psychologist, and licensed clinical social worker.
Documenting Notes and Telemedicine Codes
You will have to use one of these three types of Medicare visits when you’re billing for your services:
Healthcare providers have been given a bit of flexibility when it comes to copays and up-front costs. According to the 1135 waiver, you’re permitted to reduce or waive those copays as well as any other costs that are normally charged. This applies to all visits covered by federal healthcare programs. Make sure you have access to the complete list of telehealth codes that you’ll need to use when billing.
This is a critical time to keep accurate and up-to-date notes. When documenting your visit, be sure to indicate the type of service you provided using telehealth methods. Then, make the same notes that you would during an in-person visit conducted in the office. You’ll want to include:
Patient medical history
Review of ongoing or new symptoms
Consultative notes and data
Locations and identifying information for anyone participating in the visit
HIPAA Violation Guidelines Have been Revised
As an additional response to the COVID-19 crisis, the HHS Office for Civil Rights (OCR) is relaxing HIPAA violations against any healthcare practitioners who are working to serve and see patients through online platforms that use technologies such as FaceTime or Skype. Public facing systems such as Facebook Live are not permitted, but easing the restrictions that are normally in place can help you provide virtual care and avoid face-to-face visits.
Typically, these platforms have not been considered HIPAA-compliant. You can now use them when evaluating patients who do not need to be seen in-person. Please remember that privacy must always be your main concern, and while having patients share photos or texts with you through their phones or mobile devices isn’t optimal, you can use those tools if necessary.
The COVID-19 crisis has inspired the medical industry to deliver care in new ways. The use of digital and virtual services is growing and are now more available than ever. We encourage you to use these systems in order to minimize the risk of exposure. You don’t want the virus moving through your office and infecting your staff and patients. When a patient needs to see you, try a system of screening by sending automated texts and phone calls. Use a virtual visit to determine what type of urgent care is needed and make sure you are taking extra care with high-risk patients who may have compromised immune systems.
Horizon Revenue Solutions is here to help you navigate this crisis in ways that are best for your business. If you have any questions about these new telehealth guidelines, please contact us at Horizon Medical Billing. Stay safe.