Doctors doing AV support is not reimbursable time (this is also clearly stated in the 2021 E/M rules). In addition, he has had to personally spend half-an-hour on multiple occasions to help clients with tech issues before he could actually start the appointment. Maltese, DO who runs a neurology and sleep practice said that it typically takes his patients an average of 10 minutes to get set up for a telehealth visit. ![]() For example, if a patient is late or no show for a video appointment, how long should a doctor wait before moving to the next patient?Īnother physician mentioned in the MedPage Today article, Todd J. This means administrative tasks like waiting for no-shows and IT support may end up falling on the doctor’s shoulders. ![]() Video conference technology like Zoom, MS Team, and Google Meet do not have an efficient way to do front desk transfers between staff. This is because they may lack the virtual tools and skills to efficiently coordinate many of their pre- and post-visit processes. By having patients purchase an affordable device before the appointment and using a platform that could stream medical devices during a video visit, he was able to continue performing the necessary physical exams remotely.Īnother way providers are losing revenue is the increased time spent on non-clinical activities in order to make telehealth work. On the other hand, some physicians like ENT specialist Marc Dean, MD were able to take advantage of their telehealth platforms to completely convert to a virtual practice, including physical exams. In a MedPage Today article, endocrinologist Arthur Guerrero, MD notes that when patients don’t come in they can’t charge for retinal scans which his practice would typically perform for diabetics. While there are ways to facilitate physical exams over telehealth, some physicians are losing payment on procedures that aren’t easily done over telehealth. Procedures That Can’t Be Done Via Telehealth (A JAMA study of 41 California safety-net institutions found 48.5% of visits were conducted over audio-only compared to 48.1% in-person and 3.4% video.) Non-supporters are concerned about unnecessary overuse and quality of care. Many advocates cite disparity concerns for vulnerable, tech-challenged populations. California’s governor Gavin Newsome has been decried for proposing a 65% reimbursement rate for audio-only telehealth. Probably the biggest concern regarding telehealth reimbursement is whether CMS and private payers will continue to pay for audio-only telehealth visits at the same rate after the public health emergency. While most private payers have been following suit, there are always some exceptions and Medicaid ( which isn’t worth the hassle for many doctors to bill) varies from state to state. The good news is that according to CMS live interactive audio or video visits (including E/M visits) are considered the same as in-person visits and are paid at the same rate for the duration of the COVID public health emergency. This is because they are losing revenue, losing clinical time, and increasing non-clinical tasks in order to do telehealth visits. Today we’ll talk about the number one frustration for providers: telehealth is not profitable. This is the first in a series of three articles discussing each of these telehealth frustrations. ![]() No way to measure ROI and get actionable data.While everyone is doing telehealth, most are not happy with the experience for three key reasons:
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