Telehealth is rapidly gaining popularity as more and more people are embracing the idea of remote healthcare. In fact, many consumers are beginning to prefer telemedicine over in-person visits. This also causes challenges with getting reimbursed, especially with commercial payer reimbursement for telehealth.
Not only do telehealth visits make seeking healthcare easier for most consumers, it also tends to provide a more positive outcome than in-person visits. The vast majority of remote care patients claim that within their first telehealth visit, they received the care that they needed.
While the ease and quality of care are both great benefits of telehealth, it also creates financial savings on acute care visits. Yet, while the popularity of telemedicine is growing amongst consumers, many individual healthcare providers and systems are slower about jumping on board. This is due, in large part, to commercial payer reimbursement for telehealth ambiguity.
Not understanding how telehealth reimbursement works has kept numerous healthcare systems and providers from implementing telemedicine practices. They feel it’s easier to continue doing what they have always done and receiving payment in the usual way, than it is to begin using new technologies and following new practices.
However, with telehealth in demand, it’s important to understand the way that the three types of major payers provide reimbursement for remote, telemedicine visits. Having this knowledge will enable physicians to embrace telehealth, knowing that they will receive fair and competitive reimbursement for their services.
The most dependable way to be reimbursed for telehealth is through private insurance. Private payers tend to have a simple, streamlined process for reimbursing physicians that make it the best way to pay for telemedicine visits.
Commercial payer reimbursement for telehealth
Commercial payers are also known as private insurers. They tend to be very diligent when it comes to telehealth reimbursement. There are a number of telehealth benefits for both patients and physicians, replete with real-time eligibility and processing of claims.
In most states, commercial payers must provide coverage and reimbursement that is comparable to regular, in-person visits and services. Insurance plans have motivation to offer telehealth coverage, as each visit saves about $126.
However, not all payers are compliant with parity regulations, and as telehealth is still relatively new, various issues and specialist coverage are still being worked out. Overall, private insurance reimbursement for telehealth is consistent, dependable, and comparable.
Final thoughts
Commercial payer reimbursement for telehealth can be confusing because there are some inconsistencies. We recommend that you reach out to the commercial payer to find out what their latest policies are. To explore more about reimbursement or other telehealth topics, read more articles online or take free courses at Telehealthist.com.