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Electronic Visits Improve Access and Streamline Medical Billing

Health Insurance Companies Process 1 in 5 Claims Wrong

Electronic medical appointments, often referred to as e-visits, clearly offer patients improved access to care. But are they also an opportunity for increased revenue?

E-visits take place online through a secure e-mail system or patient portal. With a portal, patients log onto a protected section of your website where they enter information about their medical issue. Technology varies, but in most systems patients select their chief complaint from a list, enter details about their symptoms, and upload documents and/or pictures relevant to their condition.

Once the medical portion of the communication is complete, patients enter or verify the name and phone number their pharmacy, as well as credit card or insurance information. After patients hit “submit,” they receive a confirmation that the information has been received, and an indication of when to expect a response.

Medical requests are then triaged – often electronically – to the appropriate provider who can ask the patient for more information, request that the patient come to the office for an exam, or provide medical advice regarding treatment.  Once the provider has communicated treatment recommendations, the details of the visit can be imported into the patient’s EHR and prescriptions, if needed, can be sent electronically to the patient’s pharmacy. The patient then receives an e-mail notification to log back into the system to view their provider’s recommendations.

E-visits are an efficient way to provide care to established patients. Taking care of non-urgent medical issues online frees up time for face-to-face visits with patients who come into the office with complex issues.

Insurers that provide reimbursement for e-visits often pay only for visits that require medical decision making and produce a documentable action such as a medication change, the ordering of a diagnostic test or a referral to a specialist. An electronic visit cannot be related to an E/M service provided within the previous seven days, and there must be an existing provider/patient relationship based on a previous office visit.

Requests for medication refills, reporting of tests results, and distribution of patient education materials are not considered to be billable electronic visits.

Many payers now contract with vendors that provide patient portals, producing a seamless processing of claims, with payments made to providers on a set schedule.

If you need to submit claims outside of one of these systems, use the CPT codes when medical billing:

  • 99444: Physician online evaluation and management
  • 98969: Non-physician online assessment and management

is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

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Capture Billing helps medical practices by reducing their insurance accounts receivable and getting claims paid faster, allowing doctors to focus on providing quality healthcare to their patients without the stress of doing their own medical billing.

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The analysis of any medical billing or coding question is dependent on numerous specific facts -- including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies (as well as coding itself) are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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