Submitted by Antonio Arias, MBA, CHBME on Tue, 10/6/2015 - 8:00

MIPS 101: Understanding the New Merit-Based Incentive Payment System

Could Virtual Visits Boost Your Revenue?

Physicians and medical practice managers face a lofty challenge every day when it comes to balancing what’s best for their patients with what’s best for their bottom line. There are times when it feels like mutually beneficial solutions are hard to come by, but there may be one going unconsidered: telemedicine.

Think about the most difficult kind of day at your practice. What does it look like? For most medical practices, the “perfect storm” comes when your staff is overwhelmed, consumed with the needs of patients in the office and swamped with calls and emails, and your physicians are frustrated with the schedule, annoyed at spending so much time on follow-up visits and so little on critical patient concerns and high-level encounters. Telehealth solutions – aka telemedicine or “virtual visits” – can alleviate some of that practice-wide stress.

What is It?

For the uninitiated: Telemedicine utilizes telecommunications technology like voice conferencing and streaming media to provide long-distance patient care, medical education, and health administration. Telehealth enables physicians to consult and administer care to patients remotely, lessening the need for in-person encounters.

As healthcare becomes more tech-friendly, the provision of telehealth services is growing more common across the country. According to a Hospitals and Health Networks Most Wired survey, 27% of physician offices and 42% of hospitals already had telemedicine capabilities back in 2011!

By giving doctors the autonomy to travel freely and still consult with patients, telemedicine has already proven itself to be an empowering technological advancement for physicians. And since it provides easier access to care for individuals with chronic conditions or those in underserved rural areas, “telemed” is a welcome development for patients, as well.

Naturally, not all healthcare encounters are suitable for the telemedicine model. But many are: follow-up visits, dermatological encounters, reviewing test results, and more. Best of all, incorporating virtual visits into your routine – especially ones that can be handled by your physician assistants, nurses, or nurse practitioners – can free up physicians for higher level encounters, ultimately boosting revenue.

How do You Get Paid?

Telemedicine can be an invaluable tool for delivering preventive care and preventing hospitalizations for your patients. But earning revenue from it requires an understanding of how to bill for it – and that’s where some medical practices get tripped up.

Medicare, which has to some extent set the standard, reimburses for telehealth services when the originating site (where the patient is) is in a Health Professional Shortage Area (HPSA) or in a county that is outside of any Metropolitan Statistical Area (MSA). As you investigate how your other most common payers reimburse for telehealth, expect that model to be mimicked. 

Keep in mind, also, that telehealth can provide you an opportunity to avoid insurance altogether. Some providers are opting to allow virtual visits for a set menu of patient encounters – fevers, rashes, allergies, follow-ups – and are delivering them for a flat rate of $30 or $40 billed directly to the patient.

Regardless of whether that’s right for you, it’s worth considering whether telehealth may help you mitigate your practice’s revenue cycle management challenges. Start by checking that virtual services are covered under your liability insurance and surveying your patients on what they think of the idea. Given telemedicine’s growing popularity, you may be surprised how much they welcome it!

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Topics: Medical Billing, Revenue Cycle Management, Practice Management

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