Since the pandemic, many healthcare providers have utilized telehealth for virtual appointments with patients at home and for patients in the hospital needing specialized consults. The benefits of extending these services are very impressive for ambulatory care patients and expanding in-house specialties such as mental health. Telehealth improves access to care and enables providers to deliver care in a more efficient and cost-effective manner. It also contributes positively to healthcare outcomes and the provider’s bottom line. However, accompanying this great potential are numerous challenges associated with proper billing. State and federal agencies have policies that will be phased out and new policies to become permanent. Insurances are also making changes in telehealth coverage and benefits. It is imperative that the new mandates and payment models be implemented correctly for hospital and healthcare providers when providing telehealth services. Failure to do so will inevitably have a negative impact on the revenue gain that telehealth offers.
Recognizing these challenges, Quality Healthcare Partners (Quality) has developed a Tele-HELP service to cut through the red tape and assist in optimizing revenue reimbursements.
Quality’s Tele-HELP service is available for any or all of your current and future needs:
- Telehealth Platform Selection – We can assist you in finding an all-in-one medical office platform to easily manage the entire practice, including all locations. A comprehensive telehealth platform will allow patients to make appointments, pay bills, and get refills all online. Our experts can provide you with a selection of vendors with the capabilities and costs you are looking for. Let us do the hard work of ranking top telehealth software choices to meet your needs.
- Conduct Claim Review Audits – Quality performs a baseline assessment of your organization’s telehealth billing processes beginning with an audit of a sampling of claims. This includes a review of the UBs, the itemized patient bills, and the patients’ medical records associated with the claims. Quality will interview your key staff to ensure claims are coded correctly and provide a final summary report of recommended immediate corrective actions and long-range process improvements to be addressed.
- Training and Regulatory Compliance – Telehealth is rapidly changing. State and federal agencies are involved in mandating new billing requirements and closing out previous billing policies. Quality provides department level knowledge-based instructions, staff training, and process improvement advice to your organization.
- Interim Staffing – Need interim supervisor staffing to ensure accounts are overseen and processed correctly? Let Quality provide staffing when you have vacancies or need expert staff to assist you during high volume workloads.
- Revenue Integrity Follow-Up Audits – Quality can be retained to provide ongoing revenue integrity audits to ensure your telehealth payments are received and done correctly. Based on your needs, Quality performs follow-up audits to assess progress and provides recommendations for continued success.
Quality performs any of these services remotely or onsite, depending on your preference. We complete the effort within 30 to 90 days depending upon the size of your organization. Within measurable days, the result is a significant improvement in your telehealth reimbursement. Our consultants are highly experienced and certified revenue cycle specialists with in-depth knowledge of coding, clinical documentation, medical records analysis, and the improvement in workflow efficiency.