Telehealth delivery has taken the medical industry by storm. With the advent of new technologies and advancements in telehealth, telehealth cost savings are well documented too. Research from Gartner shows that average healthcare costs for hospitalizations reached $2750 in 2021 and will rise to $3750 by 2025. The delivery of healthcare services has also improved the convenience of invoicing and enhanced medical cost savings solutions. The new approach to providing healthcare has repeatedly demonstrated that it is significantly superior to traditional care.
As more practices adopt telehealth, they must be familiar with conducting virtual patient visits and filing telehealth billing claims. Since the onset of the pandemic in 2020, telehealth has become a very demanding service for patients across the United States. However, the recent telemedicine code changes proposed by the Centers for Medicare and Medicaid Services are tricky to understand for physicians.
Importance of PoS (Place of Service) in Medical Billing
Codes for the place of service (POS) are essential for properly submitting the claims. Making coding errors can adversely affect the telehealth cost savings for medical practices. The place of service code, as its name suggests, identifies the location where the practitioner provided the patient’s medical services. The proper treatment or procedural code has to be used in conjunction with the POS code. If not, the insurance provider will reject the claim. The description of the place of service code 2 has changed somewhat, and the CMS has added a new code to the list called POS 10. Here’s what you need to know about both codes:
This code’s explanation has been modified to account for patients who get medical care away from their homes. The site where health services are delivered or received via telecommunication technology, according to the CMS, is now described as POS 2.
This new code was introduced to the list of POS codes with the intention of focusing on patients getting medical care at home. The location where health services are delivered or received via telecommunication technology is described in the new POS 10 code.
In order to increase the specificity requirements for telehealth billing, the CMS recommended adjustments to POS 2 and developed a new code, POS 10, although as of right now, Medicare does not use the new codes in practice. According to Medicare’s news release, the healthcare sector needs a particular place of service codes for telehealth more than Medicare does. It’s relatively challenging for the in-house billers to correctly bill all telehealth patients. To make sure that your claims are submitted correctly, expert revenue cycle management companies are a great alternative. RCM companies regularly train their coding staff in order to keep them informed of any changes and result in telehealth cost savings for your practice.
Billing Challenges for Telehealth Services
A medical claims appraiser will decide whether to approve, deny, or reject a claim when the payer receives the invoiced claims. If a claim is accepted, the insurance provider reimburses the claimant at a predetermined rate. With an explanation of benefits, failed and refused claims are returned to the provider, who must then make the required modifications and resubmit the claim. This procedure might be repeated a few times until the payer finally agrees to pay the desired reimbursement or the provider consents to receive a partial payment.
Telehealth cost savings for patients sometimes cost more to the physicians. Most frequently, telehealth claims denials are caused by erroneous consideration of the originating site, distant site, and codes recognized by payers like Medicare and Medicaid, both of which place stringent restrictions on the justifications for telehealth operations. Tragically, the average annual cost of these denials is 3.3% of overall revenue.
Why Should You Consider Outsourcing Your Telehealth Billing?
Making sure you are paid for your telehealth services might be a challenging process that involves CPT code modifications. A single error in the coding process might cost providers thousands of dollars in revenue, which is often difficult to recover. So, medical cost savings solutions are important for revenue optimization. Many practitioners are using an electronic management service to give an electronic health record, or EHR, for each patient in order to simplify workflow. You may obtain a sizable amount of the data required to carry out analysis on your telehealth billed services by using EHR software.
But merely using a software system won’t provide you with the in-depth analysis you’ll need to keep expanding your practice. As you are aware, busy doctors and other practitioners frequently struggle to balance administrative tasks with other patient-centered obligations. Therefore, it is a wiser approach to outsource telehealth billing to a third-party provider. You should consider outsourcing because outsourced billing services are known for their following benefits:
- Professional and Dedicated Teams: With an emphasis on the telemedicine regulations for Medicare, Medicaid, and major insurance providers, telehealth billing companies employ skilled medical coders and billers. By increasing claim accuracy from the onset, competent staff with cutting-edge may help avoid the $118 expenditure per claim denial appeal.
- Telehealth Cost Savings: You may spend less on expertise by outsourcing your telehealth billing rather than hiring a full-time team. Even better, you won’t incur the extra overhead expenses related to expanding your practice’s employees, which will increase your chance of earning more money.
- Decreased Errors: “By far, the most frequent mistakes in claims submitted for telehealth services were connected to the place of the facility,” asserts law firm Husch Blackwell. Outsourced billing services make sure you are paid for your services by minimizing such errors.
- Faster Turn Around: Claims may be submitted in a matter of hours rather than a matter of days when you have an expert team at your disposal. Even better, using automated EHR software might result in verification expenses of less than 50 cents as opposed to the $8 needed by manual billing.