Telehealth – Great Concept, But Can You Get Paid?

I’ve always got interesting stuff coming across my desk.  This week it’s Telehealth Services.  The idea is not new, but insurance plans potentially paying for the service is.

The concept of Telemedicine is that the health care system could save considerable money, and patients could experience a heightened level of support for particularly delicate conditions, if the patient could be accessed remotely by the provider.

Obviously, this won’t work well for physical therapy and other hands on healthcare modalities, but certain treatments and conditions, such as continuous oxygen, patient history of non-compliance, high risk of emergency care interventions, medication management, etc. lend themselves to this new technology.

As technology has gotten more sophisticated and less expensive to deploy, telehealth services have become more appealing to all parties – patients, insurance companies and providers of healthcare services.

Medicare has issued very comprehensive guidelines, and many Medicaid agencies have adopted CMS’ guidelines as well.  Commercial insurance carriers address it in their provider manuals, but always with a litany of caveats as to when, if and how much they might pay.  And the documentation, coding and reimbursement rules are likely to trip up providers as they attempt to participate in this new healthcare delivery system.

The good news is that if this technology is able to deliver as promised, we could be welcoming a new breed of medical monitoring devices in our homes in the very near future.