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Physicians must stay informed regarding e-visit reimbursement regulatory and insurance policies, and should have transparent e-visit guidelines for patients.
In today’s world, digitization permeates nearly every aspect of human life, including healthcare. In particular, telehealth and e-visits have seen a rise in popularity, offering patients the opportunity for convenient healthcare. Although digital advancements in the healthcare industry come with many positives, they also carry some challenges—most notably, pertaining to billing. With an increasing number of physicians relying on e-visits and emails for care of and communication with patients, many doctors are unsure of how to ethically bill for virtual healthcare services. Physicians have to find the happy medium between not alienating patients while not undervaluing their services. Whereas modern healthcare had largely been in-person, with emails and phone calls generally reserved for non-care related issues like insurance verification and confirming appointment times, the Covid-19 pandemic rapidly shifted how the healthcare industry functioned, prompting an accelerated shift toward digital care.
Amongst the benefits of digital healthcare innovation in healthcare organizations are many new tools and systems that ramp up efficiency, including electronic health records (EHRs), telehealth platforms, and patient portals, which embody a more patient-centered approach via real-time communication. Other benefits include increased accessibility. For example, the ability to contact one’s physician online can be extremely helpful for elderly and mobility-challenged patients, as well as for those who simply have tight schedules. However, these benefits come with the conundrum of a blurred line concerning what physician-patient interactions are billable.
According to healthcare software company DoorSpace CEO Sarah M. Worthy, patients are mainly focused on clarity when it comes to physician communication and care. While patients value e-visits, they are wary of “surprise” fees, as they are used to emailing and calling physicians without being charged. Worthy urges physicians to clearly communicate with patients regarding any additional or altered fees that come along with digital services. Not only does such clarity generally avoid any misunderstandings, but it also fosters a trusting patient-physician relationship. Likewise, physicians also need assurance that their services will be fairly valued and compensated, whether face-to-face or digital. It is imperative for patients to understand that in-person appointments and e-visits require equal expertise levels as their in-person counterparts, with e-visits sometimes requiring a greater amount of preparation.
Given the evolving nature of digital innovation, physicians must stay informed of ever-changing e-visit reimbursement regulatory and insurance policies. Resources like the American Telemedicine Association gather nationwide virtual health-regulation updates, and the Centers or Medicaid and Medicare Services (CMS) provides physicians with telehealth related updates.
Prior to an e-visit, physicians should inform patients of any possible charges. It is crucial to be fully transparent, specifically when an email or call is billable. If patients have questions regarding billing, physicians should encourage open dialogues and make it a point to be accessible, offering to answer any questions. Physicians should also make sure their patients are aware of the intricacies and expertise that are involved in e-visits, ensuring that patients comprehend the value of such appointments. Bottom line, e-visit billing should have transparent guidelines so as to avoid any miscommunication with patients.
