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April 2021

Physician practices and rural hospitals continue to rebound from the effects of the COVID-19 pandemic, but it isn’t easy. There are still denials to appeal, audits to contend with, and healthcare disparities to address. This month, we’ve compiled three news stories to help providers stay abreast of industry changes. As we head into next month, what are your concerns, and how can Physician Practice Resources help? Email us at info@ppr-corp.com. Most importantly, stay safe out there.

Prepare for inevitable telehealth audits

If payers or the Office of Inspector General (OIG) haven’t already audited your telehealth claims, it’s probably only a matter of time before they do. Pay close attention to psychotherapy telehealth claims that are on the rise. Psychotherapy is actually now the most common telehealth diagnosis, according to a recent analysis.

This article outlines six OIG audits currently in effect, and it suggests that strategies to avoid risk and ensure revenue integrity when providing telehealth services:

  • Conduct a telehealth coding audit. Does the documentation support the codes billed and meet all telehealth billing requirements regarding credentialing, enrollment, and licensing?
  • Educate all telehealth providers on proper billing procedures for telehealth services.
  • Review compliance policies and procedures to ensure they adequately address specific telehealth requirements.

Also refer to these resources from CMS to ensure compliant telehealth coding and billing.

Continue to build your long-term telehealth strategy

Eighty-eight percent of consumers want to use telehealth after the pandemic ends. This means your medical practice must create a long-term strategy to address this demand. Medical practices that don’t continue to offer an option for telehealth will simply fall behind.

What questions must your medical practice answer as you look toward the future? Here are a few: What HIPAA-compliant telehealth platform will we use? How will we optimize workflows and efficiently schedule a mix of in-person and telehealth appointments? Can we improve our payment process and even collect payment up front? What are we doing to improve the patient experience as it relates to telehealth? For example, the American Medical Association (AMA) recently published an article on how medical practices can improve their telehealth etiquette. Some suggestions include making more eye contact with patients, carving out a dedicated physical space for video calls with patients, paying attention to lighting, making sure you have the patient’s phone number in case the video call drops, and more.

Finally, this recently-updated CMS telehealth toolkit is also a great resource to help providers bill correctly for telehealth and sustain telehealth efforts.

Capitalize on E/M changes in your medical practice

Two new white papers explain how medical practices can use E/M changes to their advantage—specifically to improve patient care and boost physician satisfaction. The papers, 2021 E/M Updates: What Will Happen to the Physician Note and 2021 E/M Updates: EHR Workflow and Operational Considerations, were written by Barbara Levy, MD, a former chair of the AMA/Specialty Society RVS Update Committee (RUC) and Craig Joseph, MD, a pediatrician and chief medical officer and Nordic Consulting Partners, Inc. These white papers include strategies to develop team-based care protocols to collect patient information, tips to improve workflows, ways to enhance documentation and coding, and more.

About us

Physician Practice Resources, Inc., founded in 2002, headquartered in Matteson, IL is a full service company that partners with small and large organizations to build solutions that enhance operational effectiveness, improve clinical documentation, and decrease overall compliance related risks. Our core competencies include: Consulting Services, Medical Coding, Temporary Help Services, Professional Management and Development Training, Continuing Education Webinars/Workshops and Coding Exam Preparation and Tutoring. Contact us at https://www.ppr-corp.com/about-ppr-corp/ for more information.


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