Medical billing: What you need to know
As the adoption of remote patient monitoring (RPM) and Telehealth services have increased in the past year, so has the use of earning reimbursements for RPM services with Current Procedural Technology (CPT) codes.
We spoke with two industry expert writers at Online Doctor: Mitchell Fong, Director of Telehealth Services at Renown Health, and Susy Salvo, Telehealth Specialist at Summit Healthcare Regional Medical Center to understand their experiences with medical billing, and how they were affected by COVID-19.
How was your use of RPM services impacted due to the COVID-19 pandemic?
Mitchell Fong: Since the pandemic, we have increased RPM services significantly and are expediting our prior timeline to launch RPM services for different cohorts of patients.
Susy Salvo: Our RPM use has increased approximately 200% since COVID-19. We do not have enough hospital beds for the COVID-19 patients so we developed a COVID-19 at home program where we send RPM equipment home with COVID-19 patients who are requiring less than 4 liters of Oxygen and monitor them closely with periodical phone checks. Now that CMS is covering not only patients with chronic illnesses but patients with acute conditions the use is increasing.
What advice would you give to healthcare providers who are looking to start earning reimbursements for RPM services?
Mitchell Fong: One tip would be to have a strong plan of the populations you want to focus on first and create the infrastructure to streamline the data capture (biometrics, time spent, communication notes, etc.) and documentation as well as a clear designation of who will be doing the monitoring work and oversight. It is a fine balance to have the appropriate clinical support but also a lean model to promote efficiency and scalability.
Susy Salvo: Make sure you incorporate the reimbursement workflow at the beginning of planning instead of waiting until the program is set up.
Based on your experience, what are the pros and cons of medical billing?
Mitchell Fong: The pros of medical billing are appropriate documentation for diagnosis and treatment to provide a clear understanding of the patient concern and intervention. However, the burden for documentation for compliance is so robust that it requires providers to spend significant time documenting and coding, taking away time spent with patients and adding to their workload creating burnout.
Susy Salvo: The pros of medical billing or having a medical billing service is they are experts in this dynamic field of changing regulations, timelines, required documentation and complex workflows. The cons of medical billing is that it is very complicated and healthcare entities can expend as high as 20% administrative time to bill for codes that may only receive a small reimbursement.
Qardio: Qardio’s remote patient monitoring solution, QardioMD, has a built-in billing feature which automatically tracks the time physicians spend on each patient. According to QardioMD customer, Dr. Marc Weinberg of Marc Weinberg M.D. Personal Healthcare, this innovative time tracking program “allows [physicians] to separate billing for CCM and RPM carefully, preventing potentially catastrophic duplications in time management…and protects the physician from an unnecessary audit error.”
Where do you see the future of health technology?
Mitchell Fong: Over the next 3-6 months I see health technology continuing to grow and expand significantly. I think this is the start of the digital revolution of healthcare and what I hope to see are increasing requirements and review for technology to create improved standards. We will see many new services available through technology and I believe we will continue to see a transition to a hybrid future where technology is integrated into the health system seamlessly long-term. The next 3-6 months will be critical to build on the health technology expansion we have seen in response to the pandemic, particularly from a regulatory standpoint.
Looking to implement remote patient monitoring in your practice? Find out more here »
With thanks to Mitchell Fong and Susy Salvo for their input.
Mitchell Fong, MPH, EMBA & Expert at OnlineDoctor.com
Susy Salvo, Telehealth expert at OnlineDoctor.com