If you've reviewed some of our previous articles on how to build a telemedicine program, you might have heard us use the phrase "telehealth insurance waiver."
What is this, and why is this important to your telehealth program?
Well, one of the key parts of implementing a telehealth program is to create a standard telehealth billing policy. By this we mean answering a few of these questions about your telehealth offerings:
- Will you be billing insurance for these visits, or charging patients directly?
- Will you charge different rates based on the type of telehealth visit?
- What will you charge?
- When will you charge (before the visit as a co-pay, or afterwards)?
- How will you charge (through your EHR, telehealth platform, or via mail)?
You can find more details in our article on How to Create Your Telehealth Billing Policy.
Notice the first question we included in italics: Will you be billing insurance or charging patients directly?
How you answer this question will help decide everything else in your billing policy, since billing payers (whether Medicare, Medicaid, or private) for telehealth requires different steps than just charging patients directly. While many providers do and can get reimbursed for telehealth through payers, many providers opt to offer telehealth visits as a cash-pay service, even if they're not a strictly concierge practice.
However, this can bring up some key questions. If you usually bill patients' insurance and are an in-network provider with those carriers, you have set contracts with those payers which dictate when, how, and how much you can bill.
This is where telehealth insurance waivers come in.
If you're a traditional medical practice but want to offer telehealth on a cash-pay basis, you need to have patients sign a telehealth insurance waiver. The waiver is essentially a signed agreement from the patient, saying they are choosing not to use insurance for telehealth. This can allow healthcare providers to offer telehealth visits as a direct-pay service.
The good news is as payers increasingly cover telehealth services for all patients, billing payers will get easier and easier and most practices will opt just to follow their standard billing procedures.
Keep this in mind as you define the telehealth billing policy for your practice. Before you cross your t's and dot your i's, consider also consulting your attorney to make sure your policy is ironclad and follows your contract requirements.
We'd love to hear your questions about telehealth and reimbursement!
Drop us a line in the comments.