Tele-HELP for Telehealth

With the recent enactment of the Medicare 1135 waiver, Telehealth has significantly expanded its role in healthcare.  The Medicare 1135 waiver allows a broader class of providers to use Telehealth and increases the circumstances under which it can be applied.  The benefits are very impressive.  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.  It is imperative that the new mandates and payment models be met 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 performed in the following summarized five steps:

1. Conduct a Pre-Claim Review. 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.
2. Perform Key Departmental Interviews. Quality gains vital information relevant to optimizing revenue reimbursement with face-to-face documentation compliance.  While concurrently performing the claims audit in Step 1 above, Quality interviews select members of each department that records the information used in preparing claims.
3. Provide a Findings and Revenue Impact Estimate. In this short-order step, Quality reports its findings along with a financial estimate of the impact on your revenue reimbursement.  Quality also provides a summary of recommended immediate corrective actions and long-range process improvements to be addressed.
4. Provide Knowledge-Based Training. Quality provides department level knowledge-based instructions, staff training, and process improvement advice to your organization.
5. Perform a Follow-Up Audit. Approximately 30 days after Step 4 above is complete, Quality performs a follow-up audit to assess progress and provides recommendations for continued success.

Quality performs this service remotely – or onsite, if requested.  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.

Please contact Cyndi Paulk, Vice President, Financial and Revenue Cycle Services at 318-680-0023 or CPaulk@QualityHCP.com to begin saving today through Tele-HELP!