{"id":9876,"date":"2020-04-15T20:30:12","date_gmt":"2020-04-16T01:30:12","guid":{"rendered":"https:\/\/www.billingparadise.com\/blog\/?p=9876"},"modified":"2026-03-11T07:14:08","modified_gmt":"2026-03-11T12:14:08","slug":"implementation-eligibility-payment-process-medicare-coverage-of-telemedicine","status":"publish","type":"post","link":"https:\/\/www.billingparadise.com\/blog\/implementation-eligibility-payment-process-medicare-coverage-of-telemedicine\/","title":{"rendered":"Implementation\/Eligibility\/Payment Process\/Medicare Coverage of Telemedicine"},"content":{"rendered":"

Telemedicine is rapidly becoming more mainstream and is being more aggressively adopted by hospitals. It has become one of the most essential tools for doctors. Physician adoption has seen a significant surge, with the percentage of physicians utilizing telemedicine increasing from 15.4% in 2019 to 86.5% in 2021. This rapid growth underscores the critical role telemedicine plays in modern healthcare (U.S Centers for Disease Control and Prevention). <\/a><\/p>\n

Fortunately, during this crisis, virtual healthcare is more easily accessible than other necessities. Government bodies such as the Food & Drug Administration (FDA) & the Centers for Disease Control & Prevention (CDC) are working together with private healthcare technology companies like Doctor on Demand & MDLive, enabling them to more aggressively equip as many hospitals and health systems as possible with the option for telemedicine services. Hospitals are now shutting down walk-ins so conclusively, that only emergency admissions are and intensive care patients are being permitted. So, for the other patients, telemedicine is the only mode through which treatment and check-ups can be done.<\/p>\n<\/div><\/div>[vc_single_image image=”446937″ img_size=”721 x 361″]<\/div><\/div><\/section>

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Implementation of Telehealth<\/h3>\n

Essentially, telehealth adoption is a practice where doctors can reach out to their patients virtually and perform general treatment or prescribe medicines. Since this can be done virtually, this service is essential during pandemics & viral outbreaks, like the one we are in the midst of. Telemedicine services in some hospitals are being implemented via video communication channels such as Skype & Facetime. Tech companies are providing applications with quality video call features in order to facilitate effective telemedicine services. Officials have begun implementing and expanding the telehealth adoption services. Prior to the crisis, there were about 200 networked telemedicine services that catered to patients in the rural areas, or areas where medical centers were not available. Now the number of working telemedicine networks is significantly more (fortunately continuously growing) and covers all metropolitan, semi-urban & rural areas. If hospitals or clinics or medical centers in general are not able to create their own telemedicine services, they have been encouraged to outsource and hire products that cater to their necessity.<\/span><\/p>\n

\"point-to-point\"Apart from networks, Point-to-Point Connections are also being implemented. In point-to-point connections, small healthcare centers are all clubbed together to form a single network and function as one large health facility. This ensures that rural clinics can now be connected with more centralized urban clinics and can benefit from their resources. Point-to-point connections are most suitable for Telepsychiatry & Teleradiology. But perhaps the quickest way to implement telemedicine is through applications such as CareClix or Doctor on Demand, although they are economically restrictive for certain patients. There are many other telemedicine applications that are available and patients & doctors are encouraged to choose and implement which is more suitable to them.<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/section>

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Eligibility and Reimbursement for Telehealth Adoption<\/h3>\n

Rightfully recognizing the importance of the telehealth adoption system & service, during this crisis, the Centers for Medicare & Medicaid (CMS) have expanded their health plans to cover people already enrolled with Medicare & Medicare Advantage plans. This also includes state-wise Medicare programs. This ensures that almost all of the population is eligible for telehealth services. To ensure that others who are only covered by commercial insurance are also eligible, the government is ensuring that all commercial payors inform their members that their health plans cover telehealth treatments. Accurate <\/span>patient eligibility verification<\/span><\/a> is essential to confirm coverage details and avoid claim denials for telehealth services.<\/span> To make telehealth more accessible for people, the Office of Civil Rights (OCR) & Department of Health and Human Services (HHS) have relaxed HIPAA regulations<\/span><\/p>\n

\"medicare<\/p>\n

This would allow hospitals and doctors to connect via any available and easily accessible video call featured apps, such as Skype\/Facetime. As for reimbursement the first step taken by the HHS Office of Inspector General (OIG) to permit doctors to waive deductibles & other out-of-pocket expenses associated with telehealth services, has been extremely favorable & encouraging. As commercial insurers also cover telehealth services, baring <\/span>\u00a0medical coding<\/span><\/a> changes, nothing has changed for the patient, but now the doctors have to be made more aware of the new medical codes associated with telehealth and especially with COVID-19<\/span><\/p>\n

Coming back to Medicare, currently to manage the current pandemic, the CMS addition to relaxing HIPAA regulations and waiving deductibles has also waived geographical restrictions, which would now allow more flexibility to patients to contact doctors without having to worry about their provider network contract and the CMS has also ensured it allowed doctors from Federally Qualified Health Services (FQHC) & Rural Health Clinics (RHC) to incorporate telehealth services and has made them eligible for Medicare compensation. For more information on general Medicare Telehealth Reimbursement check out this pdf from CMS<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/section>

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Scope & Range of Treatments Available Through Telehealth<\/h3>\n

Dr. S. John Korangy, founder & CEO of CareClix; a telemedicine company said \u201cEssentially we can perform a full exam with the obvious exception of not being able to physically touch the patient\u201d. It is precisely due to this encompassing scope of telehealth adoption, that had encouraged doctors to shut down walk-ins except for emergency & critical cases. Prior to the crisis Telehealth adoption was implemented was made available for Radiology (Teleradiology), Psychiatry (Telepsychiatry), Dermatology (Teledermatology), Nephrology (Telenephrology), Rehabilitation (Telerehabilitation) & Obstetrics (Tele-Obstetrics) and now other departments of medicine have also been added most notably Tele-Pathologists have allowed pathologists to collaborate research and easily track sources of infection, etc.<\/span><\/p>\n<\/div><\/div>[vc_single_image image=”446938″ img_size=”full” alignment=”center”]

Since, most patients prefer to get all their treatments from their Primary Care Physicians (PCP), telehealth adoption now aids those doctors in providing effective treatment for patients with: Allergies, Arthritic Pain, Asthma, Bronchitis, Colds, and Flu, Diarrhea, Infections, Insect bites, Pharyngitis, Conjunctivitis, Rashes, Respiratory infections, Sinusitis, Skin inflammations, Cellulitis, Sore throats, Sprains & Strains, Bladder infections, UTIs, Sports injuries, Vomiting <\/span>and it also aids Surgeons in ensuring that their patients receive proper post-op care, by allowing them to live monitor and continuously check-in on them. The best part, all of this is done virtually, ensuring that no one\u2019s safety is compromised during this pandemic.<\/span><\/p>\n

It\u2019s no exaggeration to say that telehealth challenges have been overcome as telehealth adoption has helped several practices function and operate efficiently during this crisis. So, if you are a doctor, kindly start implementing telehealth adoption & if you\u2019re a patient encourage your providers to opt for this service because telehealth adoption is one of the best-suited modes of healthcare services that can ensure quality treatment, without you ever compromising on your safety during this viral outbreak.<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/section>

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It has become one of the most essential tools for doctors. Physician adoption has seen a significant surge, with the percentage of physicians utilizing telemedicine increasing from 15.4% in 2019 to 86.5% in 2021. 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