The recent pandemic situation has forced many physicians into telemedicine visits. Even though, having telemedicine visits covered by insurance plans is a huge win, many doctors have been struggling to get reimbursed for these visits.
The reimbursement for tele-health visits in this pandemic situation has increased rapidly as compared to the last few years. However, the doctors are not being paid as per the promises made by insurance companies. Their earnings are nowhere close to what they made with in-person visits.
Telehealth has gained immense popularity among both patients and providers. On the other hand, the insurance companies were on the slower side to embrace it. The pandemic has forced them to pick up the pace. The Centers for Medicare & Medicaid Services (CMS) promised that Medicare would reimburse the healthcare providers at 100 percent in-person rate for these telemedicine visits. Private insurance companies followed them, but have been unable to keep their word. Both providers and analysts said that several bills are returned or are paid partially.
Lack of Consistency in Payments
A high level of inconsistency in payments has caused problems for healthcare providers. When the pandemic started, most of the insurance providers had no clue about the payment structure for the telemedicine process. While some of the companies have been making full payment, others have promised to do so. However, in reality, they end up paying a lot less.
During the pandemic, Medicare promised its patients to waive off co-pays during the crisis. As a result, doctors are already looking at 80 percent of what they used to get during a face-to-face consultation.
Apart from that, some serious revenues are lost as it is not possible to continue with all the lab tests. For example, retinal scans are not being done at most of the clinics. Though the procedure is affordable and simple, the patients are necessarily reluctant to go to the clinic. With time, it translates to a loss of revenues.
The American Medical Association continuously upgrade their website regarding how providers can navigate through the telemedicine payment process. Moreover, the insurance providers have also been requested to expand and improve the coverage and payment process for telehealth.
People are continuously trying to accustom themselves to the new-normal process. Telemedicine is one of the most important factors of the process. We all hope that with time, the process will become fluent, and doctors can efficiently receive their payments without any hassle.