In just six short weeks, the business of healthcare has shifted its entire paradigm about the delivery and reimbursement of patient care, including expanding the concept of what telehealth brings to the table.  While consumers of all ages have embraced technology and welcomed it into their daily lives, the healthcare industry overall has been slow to adapt to changes in access and convenience further hobbled by antiquated federal guidelines and insurance payer regulations.

However, since mid-March, the Centers for Medicare and Medicaid Services (CMS) has taken extraordinary measures to remove obstacles that had previously disallowed reimbursement for remote healthcare delivery except for rural providers.  Traditional barriers like patient and provider buy-in, reimbursement, and technology have all but fallen away in record time.  Federal and state officials from a variety of agencies have removed additional barriers to allow mental health providers, home health care workers, and rehabilitation specialists to utilize telehealth as a way to connect with and treat patients.  

Changing Initiatives in a Time of Pandemic

With COVID-19, it suddenly became critical to comply with stay-at-home orders and practice social distancing, which for healthcare providers meant caring for their patients without exposing or being exposed to the potentially deadly virus.  However, while the country is experiencing the first pandemic in over 100 years, patients still caught colds, experienced injuries, and required ongoing treatment for chronic ailments, not to mention many needed to be evaluated for COVID-19 to determine the best course of treatment. 

Key Telehealth Takeaways for Hospitals and Healthcare Providers

By waiving telehealth limitations, expansive opportunities have allowed care to proceed, both routine and emergent, while minimizing infectious contact.  Here are some of the valuable changes that have been made:

  • Waive telehealth restrictions and make remote care available throughout the U.S.
  • Relax HIPAA regulations allowing patients to access care through Skype, Zoom, FaceTime, and through audio means
  • Waive patient copays and coinsurances for COVID-19 care and assessment
  • Expand telehealth coverage to include mental health providers, physical and occupational therapists, licensed social workers, etc.
  • Allow care to be rendered from a provider’s home but billed from their currently enrolled practice location
  • Relax the Stark Law (prohibiting physician self-referrals) to allow for care to be delivered in non-traditional sites or by telehealth
  • Allow hospice recertifications to be completed through telehealth, as well as homebound restrictions for home health
  • Allow out-of-state practitioners can provide services without being licensed in the guest state

Securing Reimbursement Through Third-Party Support

With these changes come additional patient visits and changes to the coding and billing procedures necessary to secure reimbursement.  Engaging a strong, knowledgeable third-party partner to help ensure proper coding and billing is good insurance that the work being done will be captured and brought to the bottom line.

  • Medical Coding Solutions—COVID-19 coding has been outlined by the AMA and WHO (as the responsible parties for CPT and ICD-10-CM codes), but relying on a team of expert, certified coders who are well-versed in coronavirus care guidelines and coding requirements would greatly benefit the bottom line.
  • Medical Billing Solutions—Using a scalable, proficient billing team with guaranteed accuracy further ensures claims are successfully billed and all available monies are collected.

Looking ahead beyond the COVID-19 pandemic, we see a vastly altered healthcare system and the telehealth component will be difficult to stuff back into the genie’s bottle.  Whether your needs are temporary to weather the current storm or long-term to streamline operations, Infinx is available and is offering no start-up costs and guaranteed results to ensure your financial stability transitioning to telemedicine coding and billing.

Contact Infinx to learn more about telehealth coding and billing solutions through a scalable team.