United Medical Billing Service

The Complete Guide to Telemedicine

what is telemedicine

The analysis and treatment of patients from a distance using communication technology is known as telemedicine.  The World Health Organization (WHO) defines telemedicine as “Healing from a distance.”

Through the use of telemedicine, a patient can receive medical care from a doctor even when they are not there in person. Telemedicine services include examinations, consultations, diagnosis, follow-ups, medication management, and specialist consultations without the need for a patient to visit the doctor in person, using secure real-time video calls.

A telemedicine appointment usually requires the patient to share their medical history and download a telemedicine app before the appointment. The evaluation starts when the doctor and patient use the telemedicine app at the appointed time. The doctor provides advice on the next steps after the virtual session, which may include prescribing an over-the-counter drug, filling a prescription, recommending additional testing, or arranging an in-person visit for additional assessment.

We have put together the comprehensive guide to telemedicine to enable doctors and medical practices succeed at telemedicine in order to deal with the changes brought about by the pandemic.

In recent years, telemedicine has been a game-changer in the healthcare industry. The capacity to offer remote medical consultations and services has grown not just practical but also increasingly crucial as technology develops. But there are certain challenges in integrating telemedicine into healthcare, especially when it comes to medical billing. This article delves into the complex interplay between telemedicine and medical billing, highlighting both its advantages and disadvantages.

Types of Telemedicine Technologies:

Telemedicine consists of three types:

Real-time telemedicine:

With the help of telemedicine apps, patients and doctors can communicate in real time. The patient may be utilizing any HIPAA-compliant video conferencing software, or an app at home.

Remote Patient Monitoring:

Doctors can monitor a patient’s vital signs (temperature, blood pressure, blood sugar, and so on) and activities via remote patient monitoring. Patients with chronic illnesses like diabetes or high-risk patients who were just released from the hospital are frequently monitored via remote monitoring.

Asynchronous telemedicine:

This type of telemedicine involves doctors sharing patient data, including imaging tests, videos, and lab results, via a secure gateway. This type of telemedicine makes it easier for experts and general practitioners to collaborate.

The Telemedicine Transformation:

A multitude of factors have contributed to the growth of telecommunications technology:

Availability: Patients can receive healthcare from anywhere in the world because of telemedicine, which eliminates geographic obstacles, particularly in underserved or isolated locations.

Ease of use: By scheduling virtual sessions, patients can cut down on travel requirements and wait times.

Specialized Care: Access to specialists who might not be available locally is made possible by telemedicine.

Cost-effectiveness: Patients and healthcare providers can save money by using telemedicine.

Regularity of Care: From the comfort of their homes, patients with chronic diseases can receive routine check-ins and follow-ups.

Pandemic Reaction: Telemedicine has become more widely used as a way to deliver healthcare while reducing in-person contacts as a result of the COVID-19 pandemic.

Telemedicine – Emerging Trend of the U.S. Healthcare Industry

Here are some figures that back up that claim.

  • According to a recent Consumer Survey conducted by American Well, merely 8% of Americans have experienced a telemedicine visit. Over 70% of individuals between the ages of 18 and 44 are open to using telemedicine, while 73% of seniors are willing to test telehealth due to the faster service they can receive through virtual care.
  • By 2025, the telemedicine market will be valued at $130 billion globally. About half of the market share will go to the United States. As per Global industry Insights, the telemedicine industry in the United States is anticipated to surpass $64 billion by 2025.
  • The U.S. telemedicine market’s web and mobile delivery segment brought in more than $11.9 billion in revenue in 2018.
  • Between 2016 and 2017, the number of telemedicine insurance claims increased by a staggering 53%. By contrast, the increase in insurance claims for retail clinics was 7%, ambulatory surgery centers 6%, and urgent care centers 14%.
  • Popular telemedicine apps like Teladoc, MDLIVE, and Doctor on Demand state that women particularly working mothers have played a significant role in both the adoption and promotion of telemedicine.

Telemedicine’s advantages for both patients and providers

One thing is clear from the expansion of the telemedicine market in the United States: medical care delivery will undergo a significant transformation that will affect practices of all sizes. Inability to use this technology will leave providers unprepared to meet patient expectations for high-quality medical care.

The following categories of medical care are now being successfully provided by telemedicine:

  • Follow-up appointments
  • Management of chronic diseases
  • Post hospitalization care
  • Support for preventative care
  • Assistance for living facilities
  • Supplying healthcare to educational institutions
  • Common health problems like the flu, pink eye, sore throats, insect bites, diarrhea, and so on
Advantages of telemedicine for Patients:

Cost-effective medical care:

In-person consultations are typically more expensive because the physician is more likely to recommend additional testing or follow-up appointments. Additionally, telemedicine apps are now available that provide inexpensive online consultations with doctors; these services are quite helpful for those with little insurance coverage.

Increased convenience:

Patients avoid the hassle of making the trip to the doctor’s office when they have virtual consultations. Some people do not take sick from work in order to visit a doctor. One benefit for families with little children is being able to contact a doctor without having to worry about finding a babysitter.

Increased ease of access:

Online resources such as Teladoc, American Well, and Doctor on Demand provide 24/7 access to medical professionals. Patients can now consult specialists in different states with considerably more ease. Patients with mental health concerns, substance misuse disorders, or mobility impairments can receive treatment more easily because to telemedicine.
Advantages of Telemedicine for Providers:

Enhance in-person healthcare:

The goal of telemedicine is to enhance in-person healthcare by making it simpler to conduct follow-up visits, prescribe medicines, address urgent problems, and provide medical treatment when it is convenient for patients. It is not intended to take the place of the doctor-patient relationship.

Treat more patients:

Telemedicine increases a doctor’s reach geographically, reduces the amount of time needed for each patient, and facilitates the management of special care patients. All of these factors allow a doctor to treat more patients.

Future revenue growth:

If you don’t provide the convenience of telemedicine, you will lose patients and fail to draw in new ones as tech-savvy consumers expect greater ease.

Improved patient engagement:

Patients are more likely to adhere to routine health check-up recommendations and maintain better health as a result of telemedicine. Because they may take the call from anywhere, patients are less likely to cancel an online appointment.

Operational effectiveness:

Providing telemedicine consultations is a very economical option when compared to the personnel and space costs associated with seeing the same number of patients in person at your medical office.

Enhance patient experience:

By providing telemedicine as a consultation option, you may probably influence how your patients view your medical practice. At the very least, even non-users of the service would prefer to have the opportunity to exercise a telemedicine visit at a later date. In fact, it has been demonstrated that telemedicine apps that include features like scheduling appointments and obtaining medical histories have a beneficial impact on patients’ opinions of the continuum of care.
Advantages of Telemedicine for Providers:

Despite the business numbers and the benefits of telemedicine for providers and patients, the use of telemedicine has remained an exception rather than the rule. According to a press release, almost 75% of Americans say they are unaware of or lack access to telehealth options.

Radiologists, psychiatrists, and cardiologists are the experts most likely to use telemedicine, according to a 2016 Physician Benchmark Survey by the American Medical Association (AMA). The specialists with the lowest likelihood of using telemedicine include obstetricians, gastroenterologists, and allergists/immunologists. Telemedicine is most commonly used by emergency physicians, pathologists, and radiologists to communicate with other medical experts.

Antiquated Fears Regarding Telemedicine Utilization

Over the past ten years, technological developments have simplified and reduced the cost of telemedicine implementation. However, American doctors’ usage of telemedicine is far lower than it ought to be. The following are a few of the reasons why telemedicine has become more prevalent in American physician practices:

  • worries regarding telemedicine software’s adherence to HIPAA rules for the electronic exchange of medical data.
  • the need to hold a current license to practice medicine in the state where the telemedicine customer resides.
  • the requirement that a doctor-patient connection be formed in person before providing telemedicine in order to be eligible for insurance reimbursement.
  • ignorance about the range of medical services that can be delivered through telecommunication.
  • unclear billing procedures for telemedicine.
  • the idea that insurance claims for telemedicine are far lower than those for in-person consultations for the same medical condition.
  • increased chance of lawsuits for malpractice.
Five Steps to a Successful Implementation of Telemedicine

Since telemedicine is expected to become the main method through which healthcare is delivered, any traditional brick and mortar physician office that does not now provide this service needs to get ready to start doing so. The five steps for telemedicine implementation in a physician practice are as follows:

Enhance patient experience:

Generally speaking, you would have to evaluate the kinds of questions that can be effectively transferred to telemedicine consultation. List the many consultation types that you can switch to telemedicine for. What telemedicine volume projections do you have? Which kind of telemedicine app—one that functions independently or one that incorporates medical records—is most appealing to you?

Analyze your patient base according to age, location, and medical issues (such as long-term illnesses like diabetes or high blood pressure). You could choose to start your telemedicine migration efforts with a certain group in mind based on this information. You must utilize a different communication style and approach with each patient group if you want to promote the use of telemedicine. For instance, discuss the significance of routine check-ins and “anywhere” access in cases including chronic sickness, mental health issues, and drug addiction. Make phone calls or send audio information to patients who are over 65 or who have reading difficulties to provide instructions on how to utilize the telemedicine program.

Step 2: Assess the Market

Examine what your competitors are doing in your field while you review your own procedures. What kinds of telemedicine consultations are they providing? Find out from other doctors in your network who have used telemedicine in their practice what difficulties they have had converting to the new technology from both internal (staff) and external (patient) customers. What issues did these groups bring up? Did they run into any billing issues? What kind of telemedicine software do they use, and how simple was it to set up?

Step 3: Form a Team for Migration

Effective telemedicine implementation requires responsibility and leadership. In smaller practices, the personnel usually consist of one doctor and a few assistants. However, choose a single individual to take the lead in the transition to telemedicine in larger group practices. Make sure the telemedicine implementation team includes representatives from your medical billing vendor as well as nursing assistants, IT, finance, legal, and front-office departments.

Step 4: Examine Applications for Telemedicine

It is now time to select the telemedicine application that best suits your demands when you have a clear idea of what other people in the industry are doing and the particular requirements of your practice. Check with your medical billing provider to see whether your billing software has any built-in telemedicine features before you go shopping around. What telemedicine applications does the medical billing business suggest using for your clinic, as well?

Compare the following as you assess your options for telemedicine applications:

  1. How much does it cost? High-end cameras and microphones for desktop and laptop computers could be an upfront implementation expense. Additional bandwidth for high-quality video streaming, a monthly app subscription fee per user, and the price of extra IT security measures could be the ongoing expenses.
  2. Assistance with training from the telemedicine provider. In addition to providing sufficient support for patients entering onto the telemedicine app for the first time, you will need to teach your staff.
  3. Reputation of telemedicine companies. Examine internet reviews regarding the company’s technical support, software upgrades, system functionality, and ease of use.
  4. It’s time to put the software into use.
  5. Does it function flawlessly on every kind of mobile device?
  6. How many users can be supported by the app? (Applicable to extensive practices)
  7. What cutting-edge security mechanisms does the app offer, aside from HIPAA compliance, to safeguard patient data including credit card details and medical records? What extra security features does the app provide for mobile and laptop devices that are portable?
  8. Is it a standalone telemedicine system or does it interface with your EHR software?
  9. Does the platform include any additional features, such as a patient portal?

Step 5: Create an Execution Strategy

  1. Make an implementation plan after deciding on a telemedicine app. Here are some guidelines:
  2. Conduct staff review meetings on a frequent basis to make sure they are on board and prepared.
  3. Plan staff development activities.
  4. When working with an outside medical billing provider, get their opinion early on and include them in staff training and system testing.
  5. Before you go live with telemedicine consultations, practice telemedicine calls (with your personnel and the medical billing vendor).
  6. Choose a launch date for the new service and prepare staff for emails and phone calls. After the telehealth service goes live, work out a close monitoring period with the medical billing company. This will help to guarantee that you have enough support to deal with any unforeseen problems.
Billing for Telemedicine:

The same paperwork is needed for both in-person and telemedicine insurance claims. It is imperative that you utilize the code 02 (in-office consults) in conjunction with the modifier 95 for the place of service.

Reimbursements for telemedicine typically differ according on the payer, state, and practice. Furthermore, state restrictions are often changing. Therefore, before you implement telemedicine in your practice, it is essential that you comprehend the rules regarding medical coding and billing for telemedicine conversations.

To designate a telemedicine, consult as a non-in-person visit for billing purposes, add a modification to the E/M (evaluation and management) code. The remaining steps follow the same protocol as for any other claim.

Best Practices to Overcome Challenges of Medical Billing in Telemedicine:

Careful preparation and adherence to best practices are necessary for the successful integration of telemedicine into healthcare billing:

Training: Healthcare providers and billing personnel should be trained on the rules and regulations pertaining to telehealth billing.

Eligibility Verification: Confirm patient eligibility and insurance coverage prior to making telehealth appointments.

Coding Accuracy: It’s essential to code accurately. When necessary, use codes unique to telehealth, and keep abreast of changes to coding standards.

Compliance: Make sure you abide with all local, state, and federal laws, particularly those pertaining to reimbursement and licensing.

Billing Software: To expedite the process, get medical billing software that accepts telehealth billing.

Documentation: Carefully record all aspects of telehealth interactions.

Effective Communication: Inform patients about telehealth service billing, including any associated extra costs.

Telemedicine Billing’s Future

Billing procedures will adjust more as telemedicine is more thoroughly included into the provision of healthcare. Automation of coding and eligibility verification may be facilitated by technology, especially AI-driven billing systems. Simplifying the process can be achieved by standardizing telehealth billing codes and rules.

To sum up, telemedicine is changing healthcare by making it more convenient and accessible. Healthcare providers can leverage telemedicine’s potential to enhance patient care and optimize revenue management by adopting best practices and adjusting to changing legislation, even though medical billing in this context poses certain problems. Future telemedicine billing promises even more precision and efficiency in healthcare financial operations as technology develops.

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