Telehealth Billing: Adapting to a New Normal

Posted by Smart Data Solutions on September 21st, 2022
Smart Data Solutions

Saying that the COVID-19 pandemic upended life as we know it is an understatement. Over a short period of time, people, places, and businesses had to completely reorder their daily lives to accommodate a new way of living. 

Many businesses had the luxury of moving their employees to remote work, and the healthcare industry followed suit by providing enhanced telemedicine options. Medical institutions took the lead in expanding their telehealth services, allowing patients to stay home safely while still being able to meet with their healthcare Providers. While this shift has provided many individuals with more flexibility, it has added complexities to telehealth billing.

Refining the process for telehealth claims processing and billing with the support of a technology solutions provider such as Smart Data Solutions (SDS) can help Providers and Payers alike incorporate this new telemedicine norm into their everyday workflows.

How Telemedicine Changed the Healthcare Industry

Telehealth certainly existed before the pandemic, but utilization was low. Between the buildout of remote capabilities and regulatory changes as a result of the pandemic, telehealth quickly became the norm for many Providers. However, because of the scarce adoption pre-pandemic, the infrastructure to handle telehealth billing claims was lacking. The CAQH Index stated the following about this problem: 

“As telemedicine services expanded, new policies and requirements were implemented which introduced additional and varied administrative complexity to health plans and providers, often resulting in costly and time-consuming manual work that occurred outside the workflow.”

Today, many of those complexities have yet to be resolved. The post-pandemic labor shortage and subsequent “catch-up” have left little time for administrators to efficiently and effectively manage their patients’ telehealth claims. Many institutions are still utilizing manual claims processing as they cannot find the time or resources to implement a new system, and the nuances of the claims don’t lend themselves to an out-of-the-box solution.

The Role of Telehealth Billing Moving Forward

Simply put, this process is unsustainable. While telehealth has certainly decreased since the peak of COVID-19, many patients find themselves continuing to default to telehealth, opting for the convenience it provides over in-person visits. 

In a survey by the American Psychiatric Association, “43% of adults polled hope to continue telehealth services even after the pandemic is past us.”  While the population continues to age, and mobility becomes a challenge for many, telehealth is likely to continue growing, rather than be reduced.

Healthcare Providers have the imperative challenge of finding cost-efficient ways to deal with telehealth billing now and into the future. Manual claims are slower, more expensive, and less accurate than their automated counterparts. Bogging down human capital with redundant or time-consuming claims processes is detrimental to an organization’s budget and well-being. 

Partner with SDS to Optimize Telehealth Billing Services

Partnering with a technology solutions partner such as SDS will allow companies to catch up — and keep up — to the technology of telemedicine. With in-house technologists that can collaborate with your teams on custom solutions to any workflow, SDS can automate and standardize telehealth claims processing and billing workflows, allowing them to be processed faster and more economically than with manual labor. Auto-adjudication can help free-up resources needed elsewhere and help put your company on the right path to deal with the rapid technological wave that is sweeping through medicine.

There’s no doubt that the change to the claims and telemedicine billing workflow will be profound, but that doesn’t mean it has to be disruptive. Even if new codes or requirements are implemented, the benefits of automation and the standardization of telehealth billing workflows can be long-lasting, which means that upfront investments will be paid back quickly. 

SDS can help make these changes possible now and ensure a smoother, quicker response to the telehealth revolution. If you’re interested in learning more, read our article on Medical Claim Management. For more information about how SDS can support your telehealth billing services, reach out and schedule a call today! 

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