Telemedicine Expanding Access And Dictating Reimbursement Policies

While the clouds of uncertainty surround the Affordable Care Act and its assigned substitution, the American Health Care Act, legislators in Washington and around the nation are pushing ahead with the proposition to direct and repay administrations provided by the means of telemedicine.

So, what type of impact these changes have on your income cycle, will the revenue growth of your facility get stuck,  will the ROI get marginalized, what’s in store for the Medical billers and coders associated with your facility?  Let’s find out.

Providing patient care utilizing electronic means is represented by the AUA Telemedicine Workgroup as an electronic revolution that is changing the very embodiment of how doctors conduct their practices.

The individuals working on this attest to the fact that telemedicine is an advancement, which is practically identical to the evolution of printing press, sighting its ability to change culture and medicine for the good of the patients. Governments are scrambling to make up for lost time with these innovations, forcing laws and regulations that secure patients and promote fair payments.

Keep in mind that Telemedicine may encapsulate novel advantages and even risks, contingent upon the specifics of the laws that pass.

However, the moot question that stands here is that are Patients are prepared. Well, a recent report revealed that 66% of urology patients are as of now eager to take part in telemedicine.

So, are the physicians prepared for this transition? Research from HIMSS Analytics discovers the adoption of telemedicine benefits overall practice types surged to 71% in 2017, up from around 54% out of 2014.

Of course, similar research finds that the greatest problem currently facing the outpatient market is confusion, specifically around reimbursement, physician liability and also medical billing and coding ethics.  Nearly every state has considered legislation to address these issues, but a lack of uniformity contributes to ongoing confusion.

The Reimbursement Red Tapes

Along with each state, laws must dictate if and how doctors may provide tele-health services. By 2017, nearly every state codified the process to establish a valid doctor-patient relationship via tele-health and prevent payers from mandating an in-person visit before tele-health use. But the types of procedures that patients are eligible for and the payment structure vary from state to state.

Gradually, states implement pay parity laws that require payers to reimburse tele-health procedures to the same extent as in-person services.

From January 2017, it is mandatory for 31 states and the District of Columbia to have private payer parity and 20 states and D.C. require Medicaid parity.

The states of Alaska and Arizona are the only states that impose partial parity, where all the services are not covered. In Arizona, legislators have come to add services on a piecemeal basis.

Coverage of telemedicine consultation services for trauma, burn, cardiology, infectious diseases, mental health disorders, neurologic diseases, and dermatology took effect on Jan. 1, 2015.

Pulmonology services were added in 2016, and this year, the Arizona Urological Society (AZUS) led a campaign to include urology to the list of telemedicine services that must be given insurance payment parity.