Disparities Remain in Reimbursements for Telehealth, In-Office Visits
June 9, 2014 in News
While much progress has been made in getting private insurers to reimburse physicians for telehealth services, disparities remain between payment rates for such services and in-person visits, according to a study published in the journal Telemedicine and e-Health, FierceHealthIT reports (Hall, FierceHealthIT, 6/6).
The American Telemedicine Association conducted an online survey in 2012 of its members to gauge their experiences with reimbursement for telehealth services from private payers. Respondents were located in 46 states (Antoniotti et al., Telemedicine and e-Health, June 2014).
Overall, the 2012 survey found that progress in telehealth reimbursement among private insurers has been relatively slow compared with previous surveys.
Specifically, the survey found that 81% of respondents said they received payment when they billed for telehealth services, while 19% said they were not reimbursed (FierceHealthIT, 6/6).
Of those who were not reimbursed:
- 55% said they continued to offer the services; and
- 48% said they ceased offering telehealth services (Telemedicine and e-Health, June 2014).
Compared with reimbursements for in-person care, the survey found that:
- 9% of respondents said telehealth reimbursement took longer to receive;
- 40% reported similar reimbursement time frames for the two services; and
- 51% were unsure (FierceHealthIT, 6/6).
According to the survey, respondents cited various reasons insurers could treat telehealth service claims differently than in-person claims, including:
- Billing code differences for the two services;
- Preauthorization requirements; and
- Receiving more claim denials for telehealth than for in-person services.
In addition, the researchers concluded:
- Clearer federal and state reimbursement policies could prompt private insurers to adopt more accommodating policies; and
- Providers could benefit from more education on billing and coding processes for telehealth services, as well as how to push for reimbursement (FierceHealthIT, 6/6).