Facility Fees & Telehealth Reimbursement

Thank you for your interest in this article. This specialized content was made available for a brief period to draw attention to the two TBHI reimbursement training programs. That content has now been shifted back to those training programs.

For detailed information about how you can get reimbursed for your telehealth services, you may want to consider participating in one of these two courses (or both):

Telehealth Reimbursement Strategies: Increasing Authorization & Payment (3-Hour Program)

Want to know exactly how you’ll get telehealth reimbursement? From collecting legitimate cash payments online to 3rd party payor, Medicare or Medicaid, this “how-to,” practical course will quickly outline relevant telehealth reimbursement law, regulations and proper procedures for submitting forms and successfully getting paid.

Definitions are given to help the practitioner become familiar with telehealth billing essential terms and their meanings. Issues related to procedures, approved telehealth modifier codes, permitted treatment sites, types of patient diagnoses and licensure requirements for professionals are examined. Medicare, Medicaid, and Private Pay (or private insurance) requirements and strategies are discussed in detail. Examples are provided to give guidance.  Updated specialty codes designed specifically for telehealth are reviewed in detail, as are telehealth modifier codes that are essential to getting paid.

Practical suggestions are at the core of this training experience. A range of support documentation and materials are included to effectively equip you to maximize reimbursement for telehealth. Although the program has a particular focus on telebehavioral and telemental health reimbursement, principles are applicable to all telehealth billing and coding professionals. Join us today and learn how to maximize payment for telehealth!

Maximizing Telehealth Reimbursement: New Billing, Coding, Credentialing Strategies for 2019 (1-Hour Program)

Not sure if you or your organization will get paid for telehealth, telebehavioral health, or telemental health practice? This webinar will explain a number of legal, ethical and successful strategies to get paid for telepractice today. Two types of credentialing will also be discussed to help you to decide which applies to you, and how to most quickly and easily achieve the credentialing that you need.




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3 comments on “Facility Fees & Telehealth Reimbursement

  1. Hello Dr. Maheu,

    This information seems to be exactly what we need. We are a telemedicine company that provides behavioral health for substance use and co-occurring mental disorders. This means we provide services to our patients where ever they have the time for a 1 hour audio or video session with a counselor.

    In order to help more people, especially on regards to the opioid crisis (of the legal and illegal variety), we have to expand our services to include Medicaid/Medicare billing because most people simply cannot afford even our very reasonable fees with personal financing.

    We have compiled a list of 10 states to apply to for services, using info taken from SAMHSA and CMS sites. However, as you are well aware of, it can be quite the task navigating and understanding that material as each state has it’s own provider enrollment process and billing; though there are some similarities across the board.

    I’m going to delve into the materials above to continue our quest, and should we have further questions I hope myself or the office manager, who is actually doing the submission part can contact you for suggestions on mentoring through this process, get or info on is it best to hire a billing firm for a short time until we become more versed in these matters.

    PS…I tried to rate this post 5 stars, but accidentally clicked the first star.

    • Mr. White,

      Thank you for your kind words. I’m glad to see that the time I spend writing has been of value to you. As for hiring a billing firm to do your work for a while, I’d be leery of the average billing firm. Several years ago, one of the groups I consulted with had the same interest. They polled 16 different billing services and found that none of them billed correctly. Rather, they said they knew exactly how to bill for telehealth, but in fact, they were using the same old codes as they had been using for in-person care. Unfortunately, deception among billing companies seems to be common when billing for telehealth.

      The heart of the problem, of course, is that the unwitting professional trusts these groups to know what they are doing. As you know, Those very same professionals are the ones who put their signatures on each of the HCFA 1500 forms used for reimbursement. (HCFA 1`500 forms are the official standard forms used by providers to submit bills/claims for reimbursement for health services. The HCFA 1500 contains patient demographics, diagnostic codes, CPT/HCPCS codes, diagnosis codes, units, etc.) The requirement that the treating professional sign each HCFA 1500 form submitted then, is the way that insurance companies legally assure that the professional has reviewed all reimbursement requests, and literally signed off on the codes being used, attesting to their accuracy. It falls on the professional then, to know how to bill correctly regardless of what the billing company claims to know.

      That’s why we have developed our 3-hour, 100% online reimbursement course. You’ll find it listed about 2/3 of the way down our individual course list, and entitled, Telehealth Reimbursement Strategies: Increasing Authorization & Payment” If you want to go to it directly, click this link. You, your clinical staff and your billing representative(s) can take it. TBHI gives 15% discounts to parties of three or more who take the same training, so if you have multiple providers who want to be sure to know the ins and outs of how to bill for telehealth, send your request to our contact desk with the names of all interested parties. We will send you a link for the group purchase. CMEs or CEs come with this course for everyone who needs them, except social workers. (We have approval from ASWB as the accrediting organization for social workers, but ASWB does not allow reimbursement courses to be given CE hours.) The course supplies the documents, codes and several strategies that you will need. It also allows you to ask questions of us and the TBHI community at the end of the course, in a community forum, as do all our courses.

      Two other options available to you are:

      1) Speak with the owner of the billing company to whom we refer. They are a separate group, so we do not accept responsibility for what they do, but we have trained them extensively and so far, everyone we have referred is quite pleased with their services. Their name is Coast to Coast Medical Solutions and the contact person there is Ann Stortz. Be sure to tell her that you received their name from us to get the TBHI bonus.
      2) If you want accurate, quick and private answers, engage TBHI for consultation. You can meet with us within a few days time by telephone or video. We can answer the bulk of billing questions with an hour of consultation and can do targeted research to get more specific answers if needed. To purchase, go to the TBHI consultation page.

      Regardless of how you proceed, I encourage you to keep asking questions until you get answers that make sense to you — and that lead to successful reimbursement!

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