Billing Expertise and Telehealth

There’s never been a more important time to NOT be penny-wise and pound foolish.

We don’t do billing.  We do software (and we can recommend billers).  As such, when it comes to billing services, I can hear my southern roots calling with the phrase “we don’t have a dog in that hunt”.

Our #1 goal is to help make independent practices successful.  If the provider is the backbone of private practice, effective billing and collections are the legs.  After all, the best medical providers still have to pay their staff and make a living to be there for their patients.

Before COVID-19 many practices left money on the proverbial billing table.  Maybe you’re using a national billing service that only passes along your claims but doesn’t work denials and short pays.  Maybe you try to keep up with a PT internal billing person.

That may have worked to a degree in the age of normal; but nothing is normal anymore.  Most practices will need to offer some type of telehealth services to help their patients and keep up their revenue stream.  In the age of normal nearly all insurers following Medicare’s coding guidelines. Dorothy, you’re not in Oz anymore. With telehealth they’re all over the place:

  • Some require video, some allow phone, some allow phone but with different coding
  • Some want your regular Place of Service, some want Place of Service 02
  • Some want a 95 modifier, no modifier, GT modifier, GQ modifier, etc.
  • Sometimes you charge the normal copay and deductible, sometimes you don’t

It’s unreasonable to expect providers to code even close to correctly under these circumstances.  If you just let your claims go to the clearinghouse unreviewed, you’re likely to either underbill, receive many denials, or both.  It’s time to NOT be penny-wise and pound foolish.

In addition to using a qualified, certified coder and/or billing service, now is also the time to employ your software’s tools, such as custom edits.  For example, in Sevocity Premier you can set edits at the Insurer to catch coding errors before claims are sent to the clearinghouse.

If you’re a biller and have other best practices for telehealth, we’d love to hear from you – please email me at CHuddle@Sevocity.com 

Looking for a new Billing Service?  Check out our Partners Page: https://www.sevocity.com/partners/billing-services/