rcm solutions Telemedicine Providers facilities

Medical Billing And Revenue Cycle Management Solutions For Telemedicine Providers And Facilities

Telemedicine providers use technology to deliver healthcare services remotely, allowing doctors to consult with and treat patients without a traditional in-person visit. In this rapidly evolving world, telemedicine providers face multiple challenges related to billing and reimbursement. At StafGo Health, we can provide medical billing and revenue cycle management (RCM) solutions tailored to the specific needs of telehealth practices. We deeply understand the complexities of billing remote consultations, managing time-based CPT codes, and complying with ever-changing insurance policies. Whether you are into primary care, behavioral health, or specialty telemedicine services, we make sure of precise coding, faster claim submissions, and uninterrupted revenue capture.

Efficient Telehealth CPT Codes Management for Accurate Reimbursement with StafGo Health

Our well-versed coders understand that to ensure proper reimbursement, telemedicine billing requires accurate use of time and service-specific CPT codes, and therefore they correctly apply the mainly used codes 99441–99443 for telephone evaluation and management services by a physician or qualified healthcare professional and 99421–99423 for digital evaluation and management services (e-visits) via online patient portals. We are well aware that video-based telehealth visits are typically billed under 99201–99215, using the appropriate place of service (POS 02 or 10) and modifier -95 to indicate synchronous audio-video communication. For remote patient monitoring (RPM), practices often use codes like 99453 (initial setup and education), 99454 (supply of devices), and 99457–99458 for ongoing monitoring and clinical management.

Why Outsource Medical Billing And RCM To Stafgo Health For Your Telemedicine Practice?

Main concerns faced by telemedicine providers are time-based CPT coding, ever-changing payer rules, and the requirement of accurate documents. Due to these concerns, Telemedicine providers have to face more denials, underpayments, or compliance issues. At StafGo Health, we specialize in handling issues related to telehealth billing and revenue cycle management. Our team used to stay ahead of changing regulations, perfect in the application of telemedicine CPT codes and different modifiers. By outsourcing your RCM services to us, you will benefit from clean claim submissions promptly. We can also help you to capture revenue from remote patient monitoring, digital check-ins, and virtual consultations. We can help you with expert support, improved collections, faster reimbursements, and the freedom to focus on the best patient care, not to struggle with paperwork.

Common RCM Challenges Faced by Telemedicine Providers

Incorrect use of Place of Service (POS) and Modifiers- Telemedicine practices generally use incorrect POS codes (02, 20) or missing modifiers (95 or GT), which can lead to a large number of denials.
Inconsistent Payer Policies Across States - Inconsistency in payer policies creates a huge problem in Telemedicine Provider Practices. Each insurance payer has different policies regarding eligible services, coverage, etc. This inconsistency led to claim rejections and delayed payments.
Evolving CPT and HCPCS Codes - In the absence of expert help, it is becoming difficult for Telemedicine Providers to stay compliant with these ever-evolving regulatory guidelines. Telemedicine billing requires the accurate use of these constantly changing CPT and HCPCS Codes.
Documentation Requirements for Virtual Encounters- As the visits are virtual in Telemedicine Provider Practices, there are chances of missing proper clinical documents. However, payers require the proper time logging and other essential documents as needed in in-person care. Errors in these documents can lead to audits or claim denials.
Technical Platform and Modality Mismatches - Use of the unapproved technical platforms can lead to non-payment because many insurance companies restrict reimbursements to some telehealth platforms or modalities. This mismatch in modalities can lead to claim denials.
Coding and Reimbursement Gaps for Audio-Only Visits- The chances of reimbursement of video consultations are quite high compared to audio-only visits. Audio-only claims may have reduced coverage chances, leading to underpaid services.

Solving Your Telemedicine Practices' Challenges with StafGo Health

Accurate Use of POS codes and Modifiers- Our certified experts correctly apply the POS codes (e.g., POS 02 for telehealth or POS 10 for home) and modifiers to ensure minimum denials.

Up-to-Date Telehealth Coding & Modifier Accuracy— Our certified coder stays updated with the latest CPT, HCPCS, and telehealth-specific modifiers, which enable them to submit claims correctly the first time, which reduces the denial rate and enhances the reimbursement rate.

Payer Policy Intelligence for State & Federal Programs- Our Team makes a billing strategy according to payer guidelines. Whether you are providing services through virtual check-ins or full video consults, our team makes sure that you are getting reimbursed appropriately and on time.
Compliance-Focused Documentation Support - We provide comprehensive Documentation support to your staff in maintaining correct clinical documentation, including time-based logs, consent forms, etc. So that your practice stays compliant and there are fewer chances of audit risks.
Audio-Only and Video Visit Reimbursement Optimization - Our team better understands the problems that occur due to mismatches in the technical Platform and Modalities. We ensure the accurate code selection and justifications so that you don't lose a single dollar on reimbursable services.
End-to-End Revenue Cycle Oversight - StafGo Health provides end-to-end RCM solutions. From patient eligibility checks to performance reporting and payment of claims, we provide the full cycle of RCM services. Our team helps your staff with every step of your billing cycle.