Telehealth Billing Services: The Key to Maximizing Reimbursement and Minimizing Hassles

Telehealth is here to stay, with millions turning to virtual healthcare services during the COVID-19 pandemic. For example, a recent report showed that over 28 million Medicare beneficiaries accessed telehealth, marking a seismic shift in the healthcare landscape. However, many telehealth providers faced a startling roadblock: increased claim denials and low reimbursement rates. Why? Because telehealth billing brings unique challenges, and many providers struggle to navigate its complexities, leading to reduced revenues.

The good news is, with proper telehealth billing processes, you can capture the full value of your services and ensure smooth, consistent payments. Here’s a closer look at common telehealth billing pitfalls and how to overcome them to keep your revenue flowing.

Common Telehealth Billing Errors & How They Affect Your Practice

While telehealth opens new doors for patient care, it also presents unique billing challenges that can drain your resources and impact your bottom line. Here are some common telehealth billing pitfalls and how they can derail your practice:

1. Inaccurate Diagnosis Codes

Telehealth billing requires precise diagnosis codes, as any discrepancy can lead to claim rejections. With frequent updates to ICD-10 codes, staying current is essential. A single wrong code could trigger a cascade of issues, including delayed payments and rejected claims.

2. Procedure Code Confusion

Telehealth services use specific CPT codes that often differ from those used for in-person visits. Misalignments between the service provided and the codes used can lead to claim denials. It’s critical to know which codes apply to telehealth consultations, especially since some codes may vary depending on the technology or communication type (audio-only vs. video).

3. Incomplete Claim Forms

Claims that lack essential information—such as patient details or provider NPI numbers—are often flagged and denied. Ensuring accurate and complete information on each claim is crucial, as even a small typo can result in delays and lost revenue.

4. Incorrect Place of Service (POS) Codes

Using the wrong POS code is a common mistake in telehealth billing. For example, using a code intended for in-person visits can lead to automatic rejections. Specific telehealth codes like POS 02 and POS 10 are designed to differentiate between outpatient and professional service settings, so it’s essential to use the correct one.

5. Misplaced Modifier 95

Modifier 95 is used to indicate a telehealth service, but incorrect placement or unnecessary use can trigger claim rejections. It’s important to know when and where to apply Modifier 95 to ensure claim accuracy and prevent denials.

6. Lack of Detailed SOAP Notes

For telehealth billing, thorough documentation is essential. SOAP notes provide detailed information on the telehealth encounter, and without this level of detail, it can be challenging to support the level of service billed, leading to under- or over-coding, both of which can impact reimbursements.

Boost Revenue with Sirius Solutions Global: Experts in Telehealth Billing

Telehealth billing can be a hassle, but it doesn’t have to be. By partnering with experienced billing professionals, like the team at Sirius Solutions Global, you can avoid these common errors and maximize the value of your telehealth services. Here’s how Sirius Solutions Global can help you stay compliant and optimize your revenue streams:

Accurate Coding & Documentation

Our certified billers ensure that your claims use the correct telehealth CPT and diagnosis codes. They meticulously analyze SOAP notes, ensuring that all details are captured for accurate reimbursement.

Expertise in Telehealth Regulations

Telehealth billing regulations are constantly evolving. Our experts stay on top of the latest updates to ensure your claims are always compliant with current CMS and payer guidelines.

Minimized Claim Denials

By accurately using POS codes and Modifier 95, our billers reduce the risk of claim rejections. This attention to detail helps ensure you get paid the first time, without the back-and-forth of denials and appeals.

Complete and Accurate Claim Forms

Our professionals double-check every claim for accuracy and completeness. They ensure that all necessary patient and provider details are included, helping to avoid common denial triggers like missing or incorrect information.

Specialized Technology Solutions

Sirius Solutions Global leverages cutting-edge claim scrubbing software and Electronic Health Record (EHR) systems to streamline the billing process. These tools not only increase accuracy but also accelerate the claims cycle, ensuring faster payments and fewer errors.

What to Expect When You Choose Sirius Solutions Global for Your Telehealth Billing

By choosing Sirius Solutions Global, you’re not just getting a billing service—you’re gaining a partner committed to helping your practice thrive. Here’s what you can expect:

Increased Revenue: With fewer denied claims and faster reimbursements, you could see a boost in revenue of up to 20%.
Reliable Cash Flow: Our efficient billing process ensures timely payments, allowing you to maintain a steady cash flow and invest back into your practice.
Focus on Patient Care: With billing taken care of, you can devote more time to your patients and their well-being.
Peace of Mind: Our expert team understands the nuances of telehealth billing, giving you confidence that your claims are handled accurately.
Comprehensive Support: From dedicated account managers to regular updates on telehealth billing trends, we’re here to support your practice every step of the way.

Let Sirius Solutions Global Elevate Your Telehealth Billing Today!

Telehealth services can unlock new revenue streams for your practice, but only if you have the right billing processes in place. Avoid the common pitfalls, reduce denials, and optimize your revenue by partnering with Sirius Solutions Global. Our experienced team will handle the complexities of telehealth billing, allowing you to focus on delivering exceptional virtual care.

Get started today with Sirius Solutions Global, and let us help you achieve a 98% first-pass clean claim rate for your telehealth services.

Ready to boost your telehealth revenue and streamline your billing? Contact Sirius Solutions Global now to learn more about our specialized telehealth billing services and see how we can help your practice succeed.