For all the societal challenges we are facing today due to the COVID-19 Public Health Emergency (PHE), one change happened very quickly with virtually no resistance and was absorbed in record time. Telehealth has quickly become a standard operating procedure and seen as a valuable and essential tool that should be continued long term.
Even with consumers trending towards convenience and accessibility, as well as the growing shortage of physicians, telehealth was largely ignored as a viable alternative to traditional care. Before the COVID-19 pandemic, telehealth was viewed by governmental agencies and insurance carriers as something only suited for rural care where physicians weren’t readily available.
4 Unexpected, but Positive Outcomes
In mid-March, faced with an exponentially growing national health catastrophe, the Centers for Medicare and Medicaid (CMS) and, almost simultaneously, most commercial payers announced they were temporarily allowing clinicians to provide care to patients by communicating through electronic means. Suddenly, faced with an unknown contagious virus, telehealth made perfect sense.
Roadblocks vanished. There had always been concern that clinicians and patients would resist care delivered in a virtual setting, especially for the elderly and chronically ill that it was believed felt a great connection to their providers. Faced with new concerns, patients and physicians alike were almost instantly comfortable with this new paradigm shift.
Patients could now be seen without having to venture out during stay-at-home orders and didn’t have to expose themselves to potential illness by being in a healthcare facility or doctor’s office. Physicians could triage or provide care, including assessing illnesses (including COVID-19) and injuries, manage prescriptions, and follow-up treatment, while being reimbursed for their work at their traditional contracted rates.
- Providers who are quarantined, but healthy, are still able to see patients and provide care. There are large numbers of providers who are under quarantine, but either have patients that need to be seen or simply want to contribute to the PHE. Through telehealth, these providers can continue to participate in care delivery when they are most needed.
New electronic technologies have become even more critical when managing telehealth encounters. It’s suddenly much easier to streamline patient intake through high-quality automated solutions. Insurance verification and benefit collections can be automated and collected in real-time. For those equipped, artificial intelligence (AI) driven prior authorizations can be submitted and status communicated to the patient almost immediately.
Additionally, for those providers affected by the new Clinical Decision Support Mechanism (CDSM) requirements when ordering advanced imaging studies, opportunities exist to electronically manage the Appropriate Use Criteria process and complete the compliance certificate.
- Physician supply and demand became a significant problem at the outset of the PHE with more help needed in those geographic areas identified as hot spots for coronavirus. With the new telehealth rules, physicians were able to provide patient triage and care from another state entirely, allowing physicians physically located in the hot spot to concentrate on the most pressing cases. State medical boards all over the country made emergency licensing decisions that eased restrictions and facilitated telehealth delivery.
As history has repeatedly shown, ingenuity always provides solutions in times of crisis. With telehealth, the regulatory changes allowed swift and effective system-wide change that greatly benefited patients and kept physicians from unnecessary exposure to COVID-19. When we find ourselves at the other end of this PHE, it seems telehealth will have earned (and hopefully receive) a permanent place in care delivery.
If your organization has questions about telehealth coding and billing, or understand further how a real-time AI-driven Prior Authorization Software can enhance your operations and efficiencies, contact us today.