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5 Resources for Implementing Telehealth & Telemedicine

5 Resources for Implementing Telehealth & Telemedicine

Although Telemedicine has been around for years, it was really the COVID-19 pandemic that expedited the need for implementing these services rapidly and on a larger scale.

According to Medicaid.gov “telemedicine seeks to improve a patient’s health by permitting two-way, real time interactive communication between the patient, and physician or practitioner at the distant site.” This can be accomplished via telephone, video calls, or through web-based applications utilizing a microphone and video camera.

In our previous article, 4 Ways Telehealth Has Changed the Landscape of Patient Care, we discussed ways practitioners can provide safe, necessary patient care while providing a cost-effective alternative to augment revenue.

To assist in navigating telemedicine/telehealth, we’ve provided five telehealth links for providing healthcare.


1. Telehealth for Providers: What You Need to Know

CMS Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) provides a 17-page document with electronic links for telehealth and telemedicine. This resource is for providers who wish to establish permanent programs. It includes links to vendors, patient monitoring, documentation tools, etc.


2. CMS List of Telehealth Services

CMS Centers for Medicare & Medicaid Services

The CMS have made available resources for medical billing and coding. This resource link contains the 2022 medical coding schedule for allowed services for Medicare telehealth services.


3. How to Get or Provide Remote Health Care

The Health Resources & Services Administration (HRSA) provides information for both patients and providers on telehealth services. Providers can get information on remote care, find recent COVID-19 reimbursement, billing, and policy changes.


4. Introduction to Telehealth for Behavioral Health

The HRSA provides information on getting started with providing Behavioral Telehealth. This may also be referred to as telebehavioral health, telemental health, telepsychiatry, or telepsychology. There are resources for developing a Telehealth strategy, billing, and preparing patients along with many other resources.


5. Is Telehealth Viable for Mental Health Needs Post-Pandemic?

The American Association of Post-Acute Care Nursing (AAPACN) provides an in-depth article meant to help nursing home facilities walk thru providing mental and behavioral healthcare in its facilities. Prior to COVID-19, long-term care facilities didn’t see the need for technology. COVID-19 proved that by utilizing smaller technology, such as iPads, residents are able to get safe, immediate mental and behavioral health care.

MedCycle Solutions provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com.

6 Positive Impacts of Effective Revenue Cycle Management

6 Positive Impacts of Effective Revenue Cycle Management

By Ranadene Tapio, MBA, CMRS, CPCS

As healthcare delivery gets more complex, patient reimbursement decreases, and patient demand increases, practices are forced to reevaluate their revenue cycle management (RCM) process.

Some people underestimate the importance of effective revenue cycle management. RCM is the lifeblood of your practice. It determines almost all key performance indicators and practice health.

Along with the obvious indicators, here are six positive impacts that effective revenue cycle management has on a healthcare practice.

  1. Collections. An effective RCM process will include a strategy for collections. This should include prompt reminders, multiple payment options and other collections best practices.
  1. Productivity. A commonly overlooked benefit of an effective RCM strategy is increased productivity for your staff. Your team will be able to spend less time chasing collections, correcting erroneous codes and reinventing the wheel. A well laid out process will be easy to follow and more efficient.
  1. Team morale. Along with increased productivity, you’re likely to see a boost in team morale as a direct benefit of a defined RCM process. When employees are productive and accomplishing goals, they are happier and find more satisfaction in their work. It’s a win/win!
  1. Bottom line. Possibly the best benefit of optimizing your RCM is an improved bottom line. You’ll be collecting more, spending less, attracting more patients and being more productive. Whether they’re hard benefits or soft benefits, they’ll have an impact on your bottom line.
  1. Patient satisfaction. With a well formulated plan in place, your practice will be running more efficiently and effectively. Patients will notice the difference that comes in better efficiency, communication and processes. In many practices, these benefits are noticed by the patients in the forms of less wait time, quicker registration and overall a more organized delivery of care.
  1. Compliance. An effective RCM process helps ensure compliance and protection of patient data.  When a process is followed, fewer errors are made, which leads to fewer compliance issues.

Is your RCM process optimized? Is it well-developed, well-defined, and well-understood by your staff?  Are you reaping the benefits of a healthy revenue cycle management process?

There are many great organizations that can help you in these areas – MedCycle Solutions is one of them. If you’re wondering how partnering in these areas could work for your practice, let’s connect.

Ranadene (Randi) Tapio, MBA, CMRS, CPCS is the Founder and CEO MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com. You can reach Randi via email at Randi@MedCycleSolutions.com or call 320-290-6448.

Revenue Cycle Impact Amid the Pandemic

Revenue Cycle Impact Amid the Pandemic

By: Winona Thomas BS HCS

According to Kaiser Health News, there has been a spike in retroactive denials for emergency department care and more patients are being caught in the middle of possibly becoming responsible for unresolved hospital bills.

Healthcare providers along with healthcare payers are finding challenges with keeping up with the evolving government guidelines for correct claim submissions of COVID-19 billing procedures. Challenges such as unnecessary claim denials, underpayment of claim payments or payment delays, and retroactive claim denials may pay tribute to increased volumes of patient billing.

In an article written in the Healthcare Financial Management Association (HFMA), Revenue Cycle leaders provide 4 tips to keep ahead of denials amid the pandemic.

  • Pinpoint the most at-risk areas – Identify areas where providers are most likely to have difficulties keeping track of varying payer requirements introduced a new level of intricacy to claim processing.
  • Strengthen team communications – As the workforce transitioned to a remote environment due to the pandemic, for health systems, that meant remote revenue cycle processes had not been fine-tuned across functions, presenting challenges for areas such as customer service and claim processing.
  • Proactively manage relationships with payers – An organization’s ability to identify changes to payer rules around COVID-19 and telehealth claims, in real time, and keep staff informed on the variances in billing rules by payer is essential to denials prevention.
  • Increase payment flexibility for patients – Health systems ramped up patient payment options — from self-service options to payment plan offerings – to ease consumers’ financial fears ex

One of the key components for healthcare providers is to be proactive with the implementation of new revenue cycle processes and procedures to facilitate improved payment and denial management strategies with healthcare payers and the consumer population.

Winona L. Thomas, BS HCS is an Account Specialist and Writer at MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more information about MedCycle Solutions services, please visit www.MedCycleSolutions.com.

Connecting with Patients Early is Formula for Success

Connecting with Patients Early is Formula for Success

There is no surprise that the cost of healthcare continues to rise creating financial hardships not only for patients but for physicians as well.  While the COVID-19 pandemic severely impacted how patients interacted with their physician’s office, it is important to understand that patients want to be financially responsible for their medical bills and have preferences on communication methods to increase revenue.

In order to improve the overall patient experience and collection of revenue, it is important for physician offices to truly understand the demographics of their patients and the differences amongst their generational behaviors.  Using a one-size-fits-all approach to communicate with patients is an outdated method and oftentimes leads to patient frustration, lack of engagement, poor retention, and missed opportunities to enhance revenue collection.

In a recent article published last month, physicians must adapt to the patient’s digital experience in order to enhance receiving payments for medical bills (Healthleaders, 2021).  Patients desire modern payment options such as a payment portal, mobile ability, texting capabilities, and/or scanning a QR code. In addition, 76% of healthcare consumers desired a contactless method that allowed them to view their statements online and make payments without the need to visit the doctor’s office.  According to (Healthleaders, 2021), the number one payment option patients desire is contactless debit and credit card options.  In addition, patients desire payment options to help them manage their medical expenses such as payment plans and/or auto-pay methods.

As a medical billing expert, EZClaim can help medical practices improve their revenue through their billing and scheduling software in conjunction with BillFlash, which provides contactless and modernized communication methods that patients highly desire.  Let EZClaim and BillFlash enhance the options to modernize your medical billing and communication systems.


ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.

Managing Complexities of Behavioral Health Credentialing

Managing Complexities of Behavioral Health Credentialing

The COVID-19 pandemic has put a spotlight on the need for mental health resources as illness, job losses, and isolation continues to create unprecedented stress levels. According to recent surveys conducted by the Larry A. Green Center, more than half of clinicians reported declining health among patients due to closed facilities and delayed care, and more than one-third noted that patients with chronic conditions were in noticeably worse health as a result. Even more striking, over 85 percent reported a decline in inpatient mental health with 31 percent seeing a rise in addiction.

With mental health access at the forefront of our minds, there is no doubt a demand for qualified professionals that can handle these complex patient needs. While the sense of urgency for these services exists, especially as more and more healthcare consumers are resuming in-person appointments, unfortunately, there are processes in place that can create unnecessary roadblocks for practitioners.

Complying with the Council for Affordable Quality Healthcare’s (CAQH) behavioral health credentialing requirements are especially challenging. Unlike traditional medicine, treatments and therapies for conditions such as addiction are not as well understood by payers. This makes it more difficult to gain or maintain the credentials necessary to submit claims for therapy services.

Ninety percent of the time counselors and therapists apply for network status are denied! That’s a striking statistic, even for seasoned professionals, and everyone can agree that appealing denials and requesting payers review credentials in greater depth are a time consuming and expensive burden. On average, the time required for behavioral health credentialing of professionals is up to five times greater than for medical professionals because of nuances specific to the industry. The turnaround for completed enrollments is slower too, on average 180 days versus 120 days. In addition, some payers will only allow certain therapies for providers without advanced degrees. Because denials for behavioral health are common, therapists must understand which therapies a network will accept and focus on therapy-specific credentialing. In the current environment, practitioners should also ensure that Telehealth or virtual appointments will be covered for the safety of all.

 

So how can mental health providers stay ahead of enrollments and avoid credentialing-related denials? Outside assistance from experts like those at TriZetto Provider Solutions offers an end-to-end credentialing service that ensures continuous payer follow up and insight into enrollment status. Our credentialing professionals are devoted to helping providers gain and maintain their credentials. We understand the nuances associated with behavioral health credentialing and have direct relationships with all major payers. TPS allows you to do what you do best – manage patient care – by alleviating the burden of credentialing and making sure you never miss quarterly re-attestation deadlines.

If your mental health services are being denied, we are here to help. Learn how solutions from TriZetto Provider Solutions can help your practice simplify credentialing.

 

TriZetto Provider Solutions is a partner of EZClaim and can assist you with all your coding needs. For more details about EZClaim’s medical billing software, visit their website, e-mail their support team, or call them at 877.650.0904.

[ Contribution: The TriZetto Provider Solutions editorial team ]