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
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
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.
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.
- Collections. An effective RCM process will include a strategy for collections. This should include prompt reminders, multiple payment options and other collections best practices.
- 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.
- 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!
- 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.
- 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.
- 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.
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.
So, it looks that there will be a lot new for E/M coding (Evaluation and Management) in 2021, and practices should start to get ready for it.
Well, it seems the only constant in the world of medical billing changes, and 2020 would only compliment that cliché. While the chaos of COVID-19 forced many unexpected changes—how you see your patients and bill for services—a bigger change is in the works for 2021. This change will complement the “Patients Over Paperwork” initiative from CMS and the AMA, which has been developed to eliminate “Note Bloat.” So, since the new year will roll out changes to E/M visits, now is the time to make sure that all parties are prepared for this long overdue and welcome change to medical billing.
Evaluation and management services have been long overdue for an overhaul. The 1995/1997 guidelines were in place well before electronic medical records, and with the growth of EMR’s, the process to document for a specific level required a lot of tedious, unnecessary documentation. (A cursory look at some of the proposed updates for E/M CPT coding and documentation requirements will verify that!)
• History and Examination: While the elements of history and examination that are pertinent to a specific visit shall be recorded, they will no longer be used to ‘score’ the level billed
• Code Selection: It will be based on MDM or time
• Medical Decision Making: It will still utilize the CMS Table of Risk. However, the wording and explanations are being updated to provide more concise language. For instance, definitions will now be included to clearly identify subjective wording like “self-limited and stable chronic illness.” The clinical example will likely be removed, and the terms are more clearly defined. We will see this same type of clarification in the MDM table. For example, the 2021 guidelines will specify that the amount and/or complexity of data to be reviewed must also include analysis.
• Time-based Code Selection: It will also be easier. The guidelines will give specific amounts of time rather than the generic estimate that we currently see attached to E/M codes. Another major advantage to the codes selected based on time, they will now include non-face-to-face services. There will also be additional add on codes—in 15-minute increments—if the time has been exceeded for the 99205 or 99215.
While changes are daunting, this change will be rewarding from a documentation standpoint. So, if you need help with training your team on these new updates, there are FREE videos available on the AMA website, or you can enlist the help of an independent consultant like RCM Insight.
One way of keeping up with these changes is to use EZClaim’s medical billing software, which is continually updated. For more details, visit their website, ezclaim.com, contact them, or just give them a call at 877.650.0904.
[ Written by Stephanie Cremeans of EZClaim ]