How powerful is Telemedicine during Chronical Disease outbreak? Have you noticed its necessity at
this time of lockdown?
Well! Then it’s time to concentrate on telemedicine or telehealth to overcome the nightmare the
world is experiencing at the moment. While the world is isolated, managing back office works are
extremely hazardous. Co-sourcing would do a great job in finding solution at present.
How can you explain Telemedicine?
Telemedicine expands the capacity for healthcare providers to diagnose and treat patients via
telecommunications where the access to healthcare and treatment is limited or less.
It allows quicker and efficient healthcare without any delay or range.
Telemedicine which otherwise is known as Telehealth, is a digital transmission of essential reports
or data such as medical Imaging, medical diagnosis and video consultation with the healthcare
professionals or specialists.
Types of Telemedicine:
1. Interactive medicine:
This is where patient and healthcare provider interact with each other through telecommunications on
live. “Live communications” is the other way to recognize it.
2. Remote Patient Monitoring:
It renders healthcare providers the possibility to use medical equipment and handle the medical
data.
3. Store and Forward:
The hospitals or healthcare providers can share patient’s information with their colleagues or other
specialists for various solutions or treatments.
Although Telemedicine and Telehealth work for similar cause, they are quite different from each
other.
According to WHO Telemedicine is providing treatment for the patient from a distance through
telecommunications.
Whereas Telehealth is utilizing the electronic information and telecommunications to provide long
distance clinical assistance. It’s not a service but a way to improve patient care.
Telemedicine and RCM:
Lower reimbursement rates is one of the critical problems telemedicine is confronting day by day.
Revenue Cycle Management allows healthcare management to pay attention on the treatment while the
RCM
company takes the charge to increase their revenue income.
As Telemedicine is a service from long distance, healthcare providers come across many challenges to
get their payments posted.
Payments does not cover many cases and hospitals find it hectic to make their revenue generation for
the further services.
Over delay in Telehealth submission is also the major reimbursement challenges faced by healthcare
professionals.
Outsourcing makes it simple and effective and stimulates healthcare providers into a comfort zone
for a ceaseless treatment facilities and encounter a seamless revenue growth.
Benefits of Telemedicine during a Chronical Outbreak:
1. Changing Chronic Disease Management for Better:
Chronic disease management considers to be the major concern for healthcare professionals and
patients.
Usually Chronic diseases have a total impact on the economy every year. One third of the population
is told to be suffering from chronic disease.
These tendencies continue and healthcare providers are looking for different ways to decrease the
cost of chronic disease management without negative impact on quality of care.
2. Access to Specialized Care:
Patients in the rural areas across the country lack the access to healthcare facilities.
They may have to drive or travel longer distance to access their primary care providers or
specialists.
They might also suffer from lack of mobility and transportation, moreover remaining stable at one
place for longer duration period becomes hard for patients. They can’t access healthcare at regular
basis.
But with telemedicine, patient can interact with healthcare specialists from home through
telecommunications.
This also increases patients to specialized care by reducing the cost of care and eliminating the
travel expenses.
Regular clinical care is possible for the worst chronic conditions and telemedicine enables required
treatment for the patients.
3. Monitor patient’s lifestyle Changes:
In terms of medication and other treatments, Chronic disease patients may have to change their way
of life and stick to the doctor’s advice.
The treatment for these patients may have changes in their diet, medication and exercises.
So, it’s patient’s responsibility to concentrate on healthcare precautions and advices provided by
the healthcare specialists.
In case if the patient denies or delays to follow the proper guidelines and medications, the
condition will get worse than before.
Telemedicine allows doctors to monitor the patient movement at regular basis. It gives the freedom
to check the patient’s health betterment and also if he/she is following the guidelines properly.
The specialists are capable of meeting or interacting with their patients anytime on video call or
other bluetooth devices to monitor patient’s weight and other health conditions.
Such possibilities paves a way for improvement of patient’s health and faster recovery.
4. New symptoms in Real time:
Patients with chronic diseases are prone to develop new symptoms from time to time. Of course, they
are unaware and would panic about the changes into their body.
Some patients will not notice the new symptoms or neither consults their healthcare specialists.
These symptoms if unnoticed or not taken care may lead to death or worsen the situation.
Specialists have the opportunity to do an open talk with the patients regarding any new symptoms or
outcomes and changes appearing in their body or health conditions.
Early notice can make the treatment easy and improve the patient’s health at an advance stage.
How RCM benefits Telemedicine during COVID-19?
It is a critical situation for the world with COVID-19 outbreak. So are the healthcare providers
too.
Healthcare providers also are moving towards collaborations with RCM companies and external entities
to improve their Revenue Cycle performance.
Vast majority believe that self payments or In-house sourcing delivered lesser impact on their
organizations.
RCM services help keeping EHR upgrading or increasing available EHR functions.
Reports state that provider efforts integrate better Revenue Cycle Management operations with
clinical operations those aren’t yet paying off.
Digital health records and billing process are hazardous when it comes to EHRs and RCM services
benefits healthcare providers by helping them with accurate data and billing process.
With less time and more work, it’s very hard for specialists to go with the In-house payments. RCM
services extend their support to healthcare providers to increase their revenue payments by
decreasing their denials.
Telemedicine Denials and How to avoid them?
Denials:
The reimbursement process is a huge task to tackle for telemedicine services and can also be
confusing and complex with guidelines. Most of the denials are reported in this area.
Telemedicine has the potential to improve access to quality care and decrease cost at the same time
coverage for these services are limited and policy dependent.
Required documentations may differ from the documents of the visit. So, research plays a major role.
Lack of determining the services that can be covered, often falls into
denials.
Inaccurate coding falls on the next line. Codes differ for the services provided. CMS no longer
requires GT modifier and codes should be known to record accurate codes.
How to avoid Telemedicine Denials?
Coverage verification: Private payers opt to offer coverage for telemedicine at vast majority. But
they are policy dependent.
So, it’s essential for the RCM company to verify patients coverage before the first encounter.
Documenting with the reference number will help you fight the denials.
Accurate documentation requirements: The insurance companies would require set of accurate documents
which includes detailed patient data.
Sometimes documentation may vary and can be the cause for denials. The patient documentation must be
accurate and complete with detailed information.
Proper and Absolute Coding: Codes differ for various telemedicine services provided. Usually CPT
codes are preferred by many payers and they also add GT Modifiers.
When billing CMS no longer uses GT Modifiers, so the payer should take the responsibility of using
accurate and absolute coding.
The payer in most cases should verify if telemedicine services meet Medicare’s requirements for a
post payment.
Stay informed in regards to the rapid changes in coding and process to use them.
Rise of Telemedicine in Covid-19:
Telemedicine is not new to healthcare, but it has been reluctant due to technical issues and
accessibility problems.
Telemedicine has risen to alter, streamline and simplify patients journey during Covid-19.
Instead of rushing to hospitals, telemedicine paved a way for patients by using artificial
intelligence like e-diagnosis, e-consent and remote monitoring from their own places without any
travel.
At present we have witnessed demand for telemedicine in different countries. Remote telemedicine
services through telecommunications technology allows to visit healthcare professionals by
preventing the risk of Covid-19.
Telemedicine also encourages to meet the essentials for expanded healthcare resources during
pandemic.
2021 Update: Telemedicine Coverage
A recent study by the Common Wealth Fund published in June, 2021 has shed some light on the future
of telemedicine in a post pandemic USA. According to the study, while the results vary according to
the different states, policymakers are considering serious changes to the telemedicine coverage
plans.
A common question is going around the healthcare industry regarding the longevity of the
telemedicine programs. The pandemic had given rise to a number of telemedicine policies. But now
that the cases are dropping down, the question is- how will it affect the existing telemedicine
coverage? Medical management teams should look out for these changes in the new future and train
their teams accordingly. Here are some pointers from the study that you might find beneficial.
22 out of 50 states made key changes in their policies to accommodate the coverage of telemedicine.
These policies focused on private insurance coverage of telemedicine.
One of the vital aims of these changes was to bring parity between telemedicine and in-person doctor
visits.
Audio-only services were also highly covered during this time. In some cases, there was a waiver for
cost-sharing too.
Insurance companies have responded to the changes quite well. But sufficient data is not available
to know if the temporary changes are there to stay for an extended period.
Behavioral care has benefitted from the boom of telemedicine the most, with patients getting regular
access to providers.
As the data suggests, though some changes like cost waivers might be lifted, telemedicine will
continue to see a rise in use.
This is an indicator that the providers and healthcare organizations can pursue investing in
telemedicine further.
We hope this article helps you understand the current implications of telemedicine on the healthcare
industry. For any queries or suggestions, please feel free to leave a comment below. For more such
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