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Telehealth Compliance Programs Are Imperative

By | Blog, healthcare management consulting, Nextgen EHR

The rapid expansion of telehealth throughout the United States as a result of the COVID-19 pandemic has allowed providers to continue to support their patients while reducing business disruption. The growth of telehealth has also encouraged businesses to leverage technology, find new ways to provide medical care, and lower costs.

Although telehealth offers tremendous provider opportunities, there are also considerable risks. The recent surge of telehealth services has significantly prompted changes to federal and state regulations and requirements. The tangled network of federal and state regulations make legal compliance for telehealth providers exceptionally challenging, reinforcing the need to have robust compliance programs and measures in place.

Providers should make sure written policies that specifically require compliance with relevant federal and state laws, regulations, and requirements have been implemented. Policies enacted prior to the outbreak of COVID-19 should be evaluated and tweaked as needed. To oversee these changes, practices should name a compliance officer, who can also take care of allocating resources to carry out compliance program integration. Along with training all staff, annual compliance program audits should be undertaken to measure compliance activity and its effectiveness. Furthermore, staying on top of evolving laws and regulations is key in maintaining successful and current enforcement policies in place.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Telehealth Still Has Room for Improvement

By | Blog, healthcare management consulting, MIPS consulting
Three-quarters of patients that received telehealth have stated they would like to see it incorporated as a standard care component in the future. However, a significant portion of patients also said that they did not know how to proceed following the telehealth visit, suggesting healthcare providers may need to implement standard follow-up care measures.
It may not be surprising to learn that, given the surge in telehealth visits, the majority of patients had not taken advantage of virtual care prior to 2020. Close to three-quarters made use of telehealth because they’d had an original appointment delayed or canceled, and more than 70 percent of respondents also had a previous appointment canceled or postponed, either voluntarily or due to the actions of the healthcare provider.
Statistics prove the interest in continuing healthcare with a telehealth option is attractive to patients, yet only 35 percent of patients stated their healthcare provider contacted them for a follow-up, and a little over 40 percent said they were aware of how they could receive future telehealth access.
The opportunities to attract even more patients to telehealth have definitely been brought to the forefront with the pandemic. Beyond canceled in-person appointments being rescheduled as virtual, there are many other chances for practices not only to retain patients but also to attract new business with a telehealth option. Comprehensive retention procedures need to be in place to keep those patients interested in telehealth from falling through the cracks.
This update is provided by CareOptimize. We provide healthcare management consultingservices and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

States Move Toward Permanent Telehealth Expansion

By | Blog, healthcare management consulting, MIPS consulting

With healthcare practices increasingly adopting telehealth access and coverage due to the COVID-19 pandemic, some states are making moves to permanently embrace the technology.

he governor of Colorado, for example, recently signed a bill expanding access to telehealth by preventing insurance providers from mandating patients have an established provider relationship for telehealth services. Remote monitoring services are now covered under the new law, and restrictions on technology, as long as the technology is HIPAA-compliant, were also removed.

In Idaho, the governor signed an executive order urging agencies throughout the state to take action to immediately solidify the telehealth rule waivers and other regulations imposed during the COVID crisis. The exemptions also extend the technologies that could be used for telehealth, permitting telehealth providers to prescribe more drugs, including drug-assisted therapy for opioid use disorder.

As the pandemic started to affect patient numbers in March, health systems and physician offices turned rapidly to telehealth as a way to preserve revenue and keep track of patients who were chronically ill. Payers made it simpler for them by covering telehealth services, and the use of telemedicine rose rapidly.

CMS relaxed many of the regulations previously preventing telehealth expansion. They extended telehealth coverage for Medicare beneficiaries and reduced the requirements that previously forced patients to be housed at certain rural locations. The agency also expanded the number of telehealth services it would pay for and permitted telehealth providers to conduct telehealth via phone.

Many of the flexibilities put into place to allow easier access to telehealth are set to expire when the health emergency ends. Confusion about continued flexibility and what will be covered at that time has led many to speculate whether or not telehealth will remain a popular choice for providers. The laws enacted by the governors of Colorado and Idaho are aimed at solidifying some of those temporary fixes to help keep telehealth a viable option.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Telehealth Results in a Safer Future for Healthcare

By | Blog, healthcare management consulting, MIPS consulting

Until recently, the main obstacles facing the general implementation of telehealth were geographical limitations and the originating point of treatment. CMS had narrowed Medicare’s payment to telehealth services that met certain criteria including using a location within a specified area of skilled rural health care shortage or that the patient received treatment at an approved facility such as a provider’s office or hospital.

COVID-19 ‘s declaration has led CMS, at least for now, to use waivers to remove those obstacles. Telehealth, though, has other challenges ahead of it.

Many people still lack access to the fundamental infrastructure that makes a virtual doctor visit feasible. Technical issues could also be problematic for those providers who likewise lack infrastructure enabling such visits. Additionally, a major challenge has been widespread reimbursement of these programs.

Hospitals and healthcare facilities with a patient-centered approach to treatment require an effective communication plan for their patients conducive to a successful telehealth program. There have also been initiatives to utilize technology networks for the healthcare sector capable of secure, real-time virtual visits to meet more patients, easily trial them, and enhance the quality of treatment. In addition, during the pandemic, virtual visits have the ability to save resources. Increasing the adoption of telehealth in a prearranged manner can make an important contribution to the efforts to screen, test, and treat coronavirus.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Embracing Telehealth Demands as a Small Practice

By | Blog, healthcare management consulting, MIPS consulting

The COVID-19 pandemic resulted in many healthcare providers unexpectedly needing to turn to virtual treatment solutions. The transition may have been relatively smooth for larger healthcare providers with greater resources, but smaller practices had to deal with even more challenges. It wasn’t until the government instituted regulatory changes to broaden reimbursement for virtual visits that the smaller practices began to believe they, too, could move in that direction. As patients began seeing their local practices offer telehealth, their interest also increased.

The very makeup of a smaller practice forces it to think more creatively in planning and adopting emerging telemedicine needs. Some items to keep in mind include patient needs, where they come from, and what technologies they and the medical staff might use to reap the most benefits. Telehealth does not necessarily have to completely replace in-person visits, but practices could offer after-hours consultations to patients or asynchronous services for patients that require ongoing care.

Smaller practices may also wish to seek out telehealth resource centers. In addition to federally funded programs, private companies such as CareOptimize offer comprehensive telehealth services. Providers should also ensure that whatever telehealth solutions they use are compliant with HIPAA regulations, even if those regulations are being temporarily relaxed.

The future of telehealth post-pandemic remains to be seen, but many of the pieces are now in place to give all size practices the ability to institute and maintain successful telehealth programs.

To read more, please visit https://www.healthcareitnews.com/news/heres-how-smaller-practices-can-prepare-continuing-telehealth-demands.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

The Latest Insights Webinar Delves Deep into CPT E/M Changes

By | Blog, healthcare management consulting, Nextgen EHR

This week, we’re back with an all-new CareOptimize Insights Webinar highlighting changes coming with CPT E/M codes.

The code changes will go into effect on January 1, 2021, so it’s time to get your providers and coders ready. This comprehensive webinar explains how to navigate all of the Evaluation and Management changes and what they mean for reimbursement, including which codes to use when, which codes belong in conjunction, and what can be reported. There’s also a 10-step guide from acdis.org on how to successfully transition to the 2021 guidelines.

The Insights2020 CPT EM Code Changes for 2021 is up for viewing on the CareOptimize YouTube channel as well as on our Insights page. Remember you can watch all of our webinars by visiting https://www.youtube.com/careoptimize.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Telehealth Leads to Better Care and Revenue with Chronically Ill Patients

By | Blog, healthcare management consulting, MIPS consulting, Telehealth

Telehealth offers critically ill patients and their healthcare providers opportunities to raise income and improve quality of treatment. Telehealth appointments frequently represent a more convenient approach versus an in-person visit, and the costs are often markedly less than an emergency room visit. Instead of making an unnecessary trip or incurring a hefty emergency room charge, patients using a telehealth platform are able to virtually talk with a physician or a nurse via computer, phone, or tablet.

For healthcare practices, telehealth appointments with chronically ill patients create several revenue opportunities. Regulations have relaxed, and Medicare offers even more leniency when it comes to reimbursing telehealth services. Physicians can now receive the same amount reimbursed for a telehealth appointment as they would for an in-person visit, leading to a more stable revenue stream. Telehealth and remote monitoring for patients with chronic conditions in value-based contracts also enables physicians to reach quality care targets and reduce unneeded readmissions, leading to greater incentive payments.

Regular communication with chronically ill patients solves multiple problems. It’s challenging to keep a consistent chronic care management program going when patients might be afraid to come into the office. Those who need a physical, follow-up visit, or have regularly scheduled appointments, can now keep up with those via virtual visits. As a bonus, providers can also more easily evaluate the home environment with the virtual visit “show and tell” opportunity.

Telehealth has emerged as a good way to provide revenue opportunities, offer more convenience, and avoid interrupting care management programs. Many providers are seeing the benefits.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

How Telehealth Is Changing the Face of Healthcare

By | Blog, healthcare management consulting, Nextgen EHR

Before the COVID-19 pandemic, telehealth was largely used as a secondary tool by clinicians and patients, and mostly for test results delivered via email. Regulatory restrictions helped make for slow adoption. Now that telehealth has been widely implemented, patients and clinicians have quickly discovered its more widespread usefulness. Positive results, especially with virtual doctor visits, ensure telehealth will likely remain a healthcare staple for the foreseeable future.

The rapid implementation of telehealth revealed its many benefits, changing the ways many providers practice. From pediatrics to behavioral health, several common specialties embraced the extensive uses of telehealth. For example, Seattle Children’s hospital was already using it in a limited capacity in the early 2000s but has since seen massive growth. They find it particularly useful when dealing with mental health issues among children and adolescents.

With geriatrics, telehealth creates a considerably greater challenge. Many patients are on numerous medications or suffer from multiple chronic conditions. Others lack even the basic technical abilities. Initiatives to bring this demographic on board are crucial, as these patients are also at significantly higher risk of becoming infected with the coronavirus. Practitioners have doubled down on ways to reach out to these patients not only to help facilitate virtual visits, but also to ensure they have sufficient food, a means of transport, and even housing.

While primary care may be the most obvious fit for telehealth, specialties such as obstetrics, orthopaedics, and even physical therapy have altered their practices dramatically to incorporate telehealth components. To read more, please visit https://medicalxpress.com/news/2020-06-telemedicine-post-coronavirus-world-common-specialties.html.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

EHR-Embedded Telehealth Saves the Day

By | Blog, healthcare management consulting, Nextgen EHR

COVID-19 has forced healthcare practices to find ways to keep their doors open and their patients served. Telehealth has been one of the most successful. A practice based in Blue Ridge, Georgia quickly adapted to the changes by instituting a telehealth system and achieving success.

Blue Ridge Medical Group initially found itself facing difficulty with ongoing patient care as businesses were forced to close. The practice was in dire need of a solution that adhered to HIPAA laws and allowed patient scheduling as well as video conferencing and billing.

After researching telemedicine technology and exploring service vendors, Blue Ridge Medical Group found an EHR-embedded platform that addressed many of its challenges, including initiating video calls with patients to provide ongoing care. Furthermore, patients were also able to use the system with minimal hassle despite many having limited tech skills.

Blue Ridge Medical Group has seen additional perks with their new telehealth program, including being able to document EHR data during a virtual visit by communicating with the patient, ensuring they don’t feel as if they are being ignored.

Telehealth has also proven to be a major plus for older patients that may not be able to physically visit the office due to certain health conditions or being too sick to leave home. These solutions allow patients to attend the all-important visits, allowing continued management of chronic health conditions and/or potential faster recuperation.

CareOptimize provides its own telehealth solutions designed to keep your practice running smoothly. Please visit our website www.careoptimize.com for more information.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, NextGen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Things to Consider as Healthcare Facilities Move to Reopen

By | Blog, healthcare management consulting, MIPS consulting

Healthcare providers, using the directions mandated by federal and local governments, locked down their facilities to avoid the spread of COVID-19. This also meant shutting down main clinical service lines and canceling in-person appointments for patients. However, vendors are beginning to open their doors once again with the pandemic subsidizing in some regions.

According to recent data collected by The New York Times, the number of reported COVID-19 cases is dropping in close to half of states around the country, with several other states showing no statistically important change.

Just as healthcare facilities have decided to refrain from in-person appointments to minimize exposure, providers will also need to evaluate safety measures to reduce patient and provider contact with the coronavirus.

According to CMS guidelines, the optimization of telehealth services should be a major priority for healthcare facilities. Providers should remain focused on providing virtual care where appropriate to reduce the risk of spread of the virus, especially if they are dealing with patients that have severe or chronic conditions.

Should a scenario arise where in-person care is required, healthcare facilities should seek tele-triage services prior to resuming in-person care. Boosting remote patient monitoring and other telehealth capabilities may also assist providers with ensuring care access for patients who need medical care but are staying away from healthcare facilities due to understandable concerns.

To read more, please visit https://revcycleintelligence.com/news/key-considerations-for-reopening-healthcare-facilities-amid-covid-19.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.