A Look at Using Telemedicine Medical Billing during COVID-19 Pandemic
As the number of cases of confirmed COVID-19, skyrockets in the United States, family physicians are consumed with trying to best care for their patients while protecting themselves and their staff.
That is why telehealth has become such a useful tool for providing care for these patients. Doctors and hospital owners can contact us through HMS Medical Billing official website for handling all their Medical Billing-related issues.
And right on cue, the AAFP recently updated its guidance on using telehealth to specifically address caring for patients during the COVID-19 pandemic.
Tips included in that guidance address how to quickly implement telemedicine in a practice, how to get reimbursed for virtual visits, and what codes to use for COVID-19. Additionally, there is specific guidance on Medicare payment requirements for these telehealth sessions.
Another great resource that allows family physicians to share their experiences using telemedicine during the pandemic is the COVID-19 Rapid Response Member Exchange, a newly created online community that includes various threads about virtual visits and related issues.
Notes about CMS Reimbursement
In one such thread about CMS reimbursement for telehealth, Steven Waldren, M.D, vice president and chief medical informatics officer for the AAFP, said documentation requirements for any form of virtual care are the same as those for documenting in-person care.
"If a code is time-based, evidence of time must be documented," he said. "If exchanged asynchronously, videos, images, and communications must be stored, for billing purposes, and retained for a duration according to state regulation. Real-time videos, such as during a video visit, or video phone calls are not required to be stored."
To bill for an office visit with place of service code 02, Waldren said there must be a real-time video component of the visit, a requirement that he said the AAFP is working to get waived.
To accomplish a video visit, he said there already are some telemedicine products on the market that practices can use. Several examples are included on the Academy's telehealth page.
Additionally, FaceTime or Skype can now be leveraged to perform video visits with patients. Visit HMS USA’s website and contact us for better Medical Billing and Credentialing experience.
Patient-informed consent was required before HHS' Office for Civil Rights announced it would use its discretionary authority to not enforce some HIPAA requirements during the pandemic, although care providers are still encouraged to notify patients that these third-party applications potentially introduce privacy risks, and they should enable all available encryption and privacy modes when using such applications.
Waldren said additional details are available in an FPM Getting Paid blog post covering telehealth rules and procedure codes for testing COVID-19 that was updated March 17 to include additional context and updates.
Family Physicians on the Frontlines
Gina Tobalina, M.D., of El Dorado Hills, Calif., told AAFP News her practice closed its doors to in-person visits this week, converting fully to video visits.
"Our volume is down, as we rescheduled all physicals and wellness visits out until June," she said. "All acute care and routine follow-up visits will be done by 100% video visits."
The practice's staff includes Tobalina and four part-time advanced-level practitioners who use EpicCare Ambulatory EMR software and have offered video visits since May 2019.
"I would describe the difficulty level of converting to full video visits as moderate," she said. "The obstacles have been patients who need help using their smartphones and navigating the steps to use an app and connect to a video visit. This is more noticeable in our over-65 population."
Patience is a virtue in this situation, and Tobalina said for the patients who cannot get connected, the visit is converted to a telephone call.
The practice has used the updated CMS billing codes for COVID-19 but hasn't received any feedback one way or another yet.
As for the response from patients so far, Tobalina said they love their video visits.
"They are relieved to be able to connect with us and to see our faces," she said. "It offers a lot of reassurance to them. They are worried about us, too, and they are glad to hear that we are OK and up and running. There are no apologies needed as they are so thankful to be able to see and hear us."
Converting to telemedicine also provides the benefit of not worrying about adequate test kits or N95 masks or other personal protective equipment. Before going virtual, Tobalina said she was testing for COVID-19 in-office while wearing PPE, and she will continue to drive into the office to test patients with suspected cases in the parking lot.
She said routine vaccines for children will continue to be given in the parking lot, as well, with the children in their parents' cars while the attending staff wears full PPE.
"I would like to highlight the confidence and comfort it brings me to know that other doctors are doing this and doing it well," she said. "We need to rely on each other for support, both tactically and emotionally."
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