What You Need to Know about Telemedicine and Insurance

The COVID-19 pandemic has had a tremendous impact on the way most people live their daily lives. More people are working from home, children are attending virtual classes, and greater effort is being made to avoid unnecessary trips to the store or even to the doctor’s office. As people continue to shelter in place, more behavioral health providers are offering telemedicine sessions as a way to provide their patients with the essential help and support they need.

The pandemic has been mentally and emotionally difficult for everyone, but for those who struggle with a pre-existing mental health condition, COVID-19 has made things even more challenging as access to treatment, support groups, and family and friends have been limited for almost a year. Fortunately, the use of telemedicine has expanded as a way to meet with a professional without having to leave the safety of home.

If your office provides telemedicine or you’re considering adding it to your list of services, there are some things you should know with regard to insurance. In today’s blog from CA Billing, we’re going to discuss how insurance companies view telemedicine and what you can do if your patients don’t have coverage. Keep reading to learn more and then give us a call to learn how we can help your business with all of your behavioral health billing needs.

What Is Telemedicine?

Telemedicine, also known as video therapy, e-therapy, or online therapy is a safe and convenient way for patients and treatment providers to connect virtually with the aid of technology. It’s similar to video chatting with a friend or family member, but it takes place with a doctor or therapist on a HIPAA-compliant web portal.

Telemedicine sessions work much the same way as traditional doctor’s visits or therapy sessions with only one significant difference — the provider and the client are not in the same location. Instead, a computer, smartphone, or tablet is used to deliver consultations and treatments in a live, interactive, (but long-distance) setting. Not only can telemedicine be used for one-on-one sessions with a behavioral health provider, but this form of video conferencing can also be used for therapist-mediated group sessions or counseling.

Benefits of Telemedicine For Behavioral Health Specialists

It’s easy to see how patients can benefit from telemedicine, but there are quite a few reasons why it’s also good for behavioral health facilities.

COVID Safety

Even though we are in a global pandemic, people still need treatment for substance use disorders and mental health conditions. Utilizing telemedicine is a way to be able to connect clients with group counseling, therapy, and psychiatrists while still being able to maintain distancing and safety protocols for your staff and your patients.

New Opportunities

If you’re looking for ways to expand your business, telemedicine can help you reach more clients in different places outside of your local area. Because it can be done from just about any location, telemedicine lets you reach out to people who may not otherwise have the means to travel to your facility.

Telemedicine and Insurance

Despite the growing popularity of telemedicine among psychologists, therapists, and other behavioral health facilities, some insurance companies have yet to get on board and still do not cover the cost of this service. While most insurance providers have increased telemedicine coverage throughout the pandemic, some patients may be denied coverage and have to pay for services out of pocket — but this will depend on the provider and the circumstances for using telemedicine instead of seeing patients in person.

To make the process more seamless, insurance providers have taken steps to make the billing process for telemedicine easier so facilities can care for their patients in a safe way while still getting timely and sustainable reimbursements. However, it is important that your in-house billing department or third-party biller becomes familiar with the subtleties and potential changes in billing codes when submitting claims for telemedicine services. We’re happy to report at CA Billing that we’ve been able to assist our clients in transitioning some of their services to telemedicine while still maintaining reimbursement rates.

Protect Yourself and Your Patients

To protect your patients from having to pay out of pocket and to ensure that claims are processed in a timely manner, you can do one of two things. Either you can take on the responsibility of checking with each patient’s insurance company to see if they are covered and at what rate you will be paid, or you can partner with a third-party behavioral health billing company like CA Billing who can do all of the legwork for you. Not only can we save you time and free up your staff so they can focus on more important things, but we’ll use our industry experience and connections to provide you with the most accurate information and the best chances for optimum reimbursement.

Efficient and effective behavioral health billing isn’t just about assigning the right codes (although that is an important part of getting reimbursed) it’s about coming up with a comprehensive and data-driven strategy that involves verification of benefits, staying current with insurance requirements, authorizations, and enlisting the help of an experienced team to handle third-party negotiations and appeals. At CA Billing, we can assist you with all of this and more. We have extensive experience in behavioral health billing related to in-person therapy as well as telemedicine services. Contact a member of our team today to schedule a free consultation.