Updates on Medicare’s Telehealth Coverage During the Coronavirus Crisis

 

The Coronavirus Preparedness and Response Supplemental Appropriations Act were passed by Congress on March 6. Due to the present coronavirus pandemic issue, this new rule enables healthcare practitioners to bill Medicare fee-for-service for patient care delivered via Telehealth.

When the President has declared a National Emergency, this legislation gives the secretary of the U.S. Department of Health and Human Services (HHS) the ability to waive or modify specific Telehealth Medicare requirements. Additionally, it broadens the scope of coverage for Telehealth services, which involve provider and patient interaction via audio and video. The patient must initiate the treatment and grant consent to be treated virtually, and the consent must be documented in the medical record before initiation of the service, according to CMS, which has reiterated that the established-relationship requirement would not be enforced.

Additionally, CMS has announced that they are waiving HIPAA privacy restrictions and permitting the use of programs like FaceTime and Skype, so Medicare Advantage plan members may be able to get clinically relevant services via Telehealth from the comfort of their own homes. As these services are now considered to be billable services covered by Medicare, the Medicare coinsurance and deductible would now be applicable, which might be very useful to patients with Medicare Advantage coverage. Additionally, the CMS has made available a very useful FAQ paper, which you can read here. This document provides additional hotlines that both medical professionals and non-medical professionals can call.

Many providers in the risk adjustment industry are wondering how the recent changes to Medicare's Telehealth coverage apply to risk adjustment documentation. Currently, it appears from the material provided by CMS that providers are now able to conduct Telehealth Medicare risk adjustment visits with the patient, but there are still many details that need to be worked out in this new area. One thing is certain: the use of technology in the documentation process is essential in busy times like now, even though there are still many details lacking about Medicare risk adjustment in the midst of the coronavirus epidemic.

The patient is unquestionably the top priority, thus many clinicians won't have the opportunity to concentrate on risk adjustment at this time. The ability to capture essential diagnosis codes for both in-person and online visits will be made possible by the technology that is already available, such as HCC coding and risk adjustment tools. This could be a good opportunity for providers to install HCC Coding technology if it isn't already there. It would be wise to take into account tools that provide a contemporaneous workflow that combines a prospective approach (during the patient contact) with a "coder empowered" or retrospective workflow.

Although it can be difficult to keep up with documentation during a pandemic crisis, using technology can aid clinicians in identifying gaps and documenting more effectively. Clinics can eventually give patients and the team more resources by receiving the extra money through risk adjustment.

With the aim of offering technology that can optimize the HCC recording process and aid in raising RAF scores, healthcare technology businesses like Inferscience provide tools specifically for doctors providing services to Medicare Advantage patients. Prospecting and code validation are quick and simple with Inferscience's HCC Assistant and HCC Validator products.

Healthcare professionals can visit Inferscience's website at inferscience.s7.devpreviewr.com or call us at 617 848 9502 to learn more about the HCC Coding technology tools we offer. At Inferscience, we want to express our gratitude to all of the healthcare practitioners in the United States.