October 19, 2020 | US Health Share

Telehealth visits for patients and physicians have spiked since the onset of COVID-19. Even though traditional insurance companies and other medical plans have started to loosen their policies on paying doctors for telemedicine, physicians still struggle to get paid.Over recent weeks and months, reimbursement for telehealth throughout the current health crisis has surged. Unfortunately, many physicians are not being paid out nearly as much as what they receive for in-person visits, partially as a result of inconsistency in policies among the various insurance plans across the US.Health insurers were not yet on board about reimbursing healthcare practitioners for telehealth services before COVID-19 hit. That dynamic has shifted somewhat since the coronavirus has plagued the nation, but compensation is still not where it could or should be when it comes to compensating doctors who carry out these services.Every insurance company has its own set of policies, codes, and modifiers. While plans like Medicare have stated that they would reimburse providers, some physicians are complaining that some bills are being returned or paid out only partially.Traditional Insurance Coverage For Telehealth Still DevelopingThe health crisis has prompted traditional insurers to revisit their telehealth reimbursement policies given the spike in demand and need for virtual visits in an effort to maintain physical distancing measures.Yet while many health insurance plans have stepped up to provide reimbursement for telehealth visits among patients and physicians, the situation is still developing and lagging across the nation.Only 26 states have put policies in place to mandate that private insurance providers reimburse healthcare providers for telemedicine services as of this writing.Compensation for telehealth services from traditional insurance plans is lagging, leaving many physicians unable to be adequately reimbursed for virtual medical visits with patients.Physicians Not Adequately Reimbursed Under Medicare For Telehealth ServicesThe Medicare situation with telemedicine also needs to iron out some issues. Right now, Medicare has promised to waive copays for patients throughout the pandemic, which means physicians will make only 80% of what they would make with in-person care.Further, patients are often required to see specific telehealth vendors when Medicare insurers do offer to reimburse for telehealth. If patients want to see their own family doctors, telehealth visits may not always be covered. Not only that, but patients must also visit a designated medical facility to use specific technology needed to connect to health care practitioners for telehealth visits. If video visits are made from any place that is not deemed to be an “originating site,” Medicare may not cover their services.Medicaid Telehealth Policies Still UnclearWhile some Medicaid administrators have cleared up their policies on telehealth visits and reimbursement, others have not. Currently, Medicaid telehealth reimbursement policies differ from one state and plan to another. Coverage for telehealth under Medicaid is still in the development phase, despite the increasing demand for such services.Considering this, many Medicaid members may still not be able to receive compensation for their telehealth services. Further, some Medicaid plans in certain states have restrictions on the type of healthcare providers whom they deem are qualified for telemedicine.Health Sharing Ministries Offer an Attractive Alternative to Telehealth ServicesWhile there continue to be issues among private health insurance and Medicaid or Medicare health plans, health sharing ministries provide an alternative to insurance for telehealth.A health sharing ministry can provide flexible and convenient access to affordable telehealth services. Some programs even offer unlimited telemedicine services with board-certified health care providers and a $0 consultation fee.Along with these perks, members have the opportunity to be a part of a group of like-minded individuals of similar Christian faith that allows them to help out their fellow neighbors while receiving help when they are in need.Health sharing saves money. Learn more now.

Day: October 19, 2020

Health Insurance and Telehealth: A Rocky Relationship