Category Archives: Telehealth

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Practice Survival: The COVID-19 Challenge

Category:COVID-19 Pandemic,Telehealth

Physician practices are facing unprecedented financial challenges secondary to the pandemic.  We have a strategy that can help. A significant number of practices are not aware of revenue generating services that are ideal for the current situation:

  • They can be performed remotely.
  • They allow practices to provide a much high level of care coordination an monitoring.
  • They represent supplemental reimbursement to current services
  • Payers have rapidly modified their requirements and reimbursement levels for these services.
  • Physicians, PAs, NPs, CNSs, and general medical staff can convert non-billable hours into revenue generating services.
  • These success depends on lessons learned from other practices. 

Consulting Services

Apollo HIT’s expert resources are led by a physician coding professional with over 20 years of experience with health IT product development and implementation. Each of these services, including telehealth, have unique and evolving compliance requirements.  They are provided at low cost. Our goal is to ensure that your practice is compliant with telehealth and other remote service requirements.

Remote Services Implementation and Compliance. Our team will assess your current use and billing practices for telehealth encounters and provide best practice recommendations. This may result in a marked improvement in efficiency and compliance, while ensuring that you have optimal billing practices.  We will also assess your practice for a range of underutilized remote services and their revenue potential – customized for your specialty and patient population.  Underutilized clinicians and staff members can be repurposed to provide these services, making up for revenue shortfalls. 

Reimbursement Potential for Remote Services.  Reimbursement varies based on volumes, but a fully engaged nurse practitioner that provides these services for 10 hours per week can generate over $50,000 dollars per year in new revenue.  These services do not conflict with reimbursement for office visits or other procedures, meaning they represent a completely new source of revenue. The services and their income potential for 50 eligible services per month are listed below:

Service Name# Services/
Month
Monthly
Revenue
Annual
Revenue
Telephone E/M Services50$4,000$48,000
Remote Physiologic
Monitoring
50$6,000$72,000
E-Visit Services50$1,750$21,000
Chronic Care
Management (Provider)
50$3750$45,000
Principal Care
Management (Provider)
50$3750$45,000
Estimated Payments for Remote Services (Medicare)

There are a number of considerations for each of these services. Many of them have new or updated requirements. All of them have specific reporting and/or requirements.

Please contact us at: Michael@ApolloHIT.com for more information.


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Ready or Not, Telehealth Takes Center Stage in a Pandemic

Category:Telehealth Tags : 

This post briefly discusses an article on the Medicare telehealth waivers published by CMS in March and April of 2020.

The article provides an overview of Medicare eligible telehealth services during the current pandemic.  It provides a list of the 238 services now eligible for reimbursement, up from less than 100 prior to March 1, 2020. Many of the restrictions limiting how these services may be provided, including the originating (patient) location, have been changed.

Because of these changes many of the barriers to providing telehealth services to Medicare beneficiaries have been removed.  Many commercial payers are offering similar incentives for the use of telehealth.

Significant changes were made to the Medicare documentation requirements for office visit evaluation and management codes 99201-99215.  The history and physical examination components of the encounter document will no longer be used to determine level of service. It will be based solely on the amount of time spent caring for the patient during the calendar day or the level of complexity of medical decision-making.  These changes were slated for January 1, 2021, but were put in place 10 months ahead of schedule, on March 1, 2020 in response to the public health emergency.

Medicare recently approved the use of telephone (audio-only) codes and on April 29, 2020 CMS made reimbursement for these services (CPT codes 99441-99443) equivalent to office visit E/M codes 99212-99214. Additional information is provided in the article.

A large number of services have now been approved for telehealth and a significant number of these have been reduced to requiring 2-way audio communication only. These codes affect many of the codes used by mental and behavioral health providers.

The article also discusses e-visit and virtual check-in services.  The reimbursement for e-visits is determined by the amount of provider time spent communicating with patient via electronic communications and other methods over a seven-day period. There are 3 codes that can be billed by physicians and other qualified healthcare professionals: 99421, 99422, and 99423. Reimbursement for code 99423 is approximately $51. It requires 21 more minutes of provider time and this time must be spent in written or verbal communication with patient. Other requirements apply as detailed in the article.

The article was originally published by the Journal of AHIMA on April 29th.  It was updated on May 7, 2020 in response to the additional waivers released by Medicare on April 29, 2020.

Reprints are available by request.  Please email Michael@ApolloHIT.com

 


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COVID-19 Physician Perspective: AHIMA Podcast

Category:COVID-19 Pandemic,Telehealth Tags : 

The American Health Information Management Association (AHIMA) hosted a podcast on the COVID-19 pandemic on April 13th, 2020 and moderated by Dan Kelly. It focused on the physician perspective and features interview with two physician health information management professionals: Dr. Michael Stearns (CEO of Apollo HIT, LLC) and Dr. Faisal Hussain (Vice President of Reventics).  The podcast is available here.