Billing for Telehealth: Best Practices and Key Questions to Ask Payers

Compared to traditional healthcare appointments, telehealth visits may offer many notable conveniences for patients and providers. But while shifting provider visits online has its benefits — including a high rate of patient satisfaction — there are still some hurdles to jump.¹ Health systems and providers may need to adjust their care delivery strategies to accommodate a shift to telemedicine services. One of the challenges they may face: determining how to handle the telehealth billing process in a way that makes patients feel confident and supported throughout the patient financial experience.

This article will explore various types and benefits of telehealth, along with telemedicine billing best practices and important questions to ask payers to improve the financial management of your health system or practice.

4 Types of Telehealth Services

Here are four ways providers can use digital information and communication technologies to offer healthcare services remotely:²

1. Synchronous. Live interaction between a patient and provider via videoconference or phone call
2. Asynchronous (aka store-and-forward). Communication between a patient and provider that is not live — including texts, image sharing and the transmission of recorded health history — so the practitioner can evaluate the patient’s case outside of an appointment
3. Remote patient monitoring (RPM). Devices (such as a heart rate monitor) that transmit data to a provider who can monitor a patient’s health outside of the office
4. Mobile health (mHealth). Digital tools to support patient health, such as discharge instructions and automatic medicine reminders

Benefits of Telehealth: Increasing Access to Care

With the adoption of telehealth, providers can improve the level of care they offer patients.³ For starters, virtual appointments may make healthcare more accessible for individuals who live in isolated areas, have limited mobility or who put off medical or health visits because they can’t find time to go. Additionally, those who have limited transportation options or who rely on others to drive them can get high-quality care without visiting a provider’s office. Telehealth can also make it easier for patients to access specialists located outside of driving distance and for multiple providers to coordinate when caring for the same patient.⁴

Providers can also create better outcomes for patients through remote patient monitoring (RPM).³ Patients with chronic diseases may be able to better manage their conditions when they don’t miss appointments. This benefit can be especially important for older patients or patients with limited mobility who rely on others to get them to and from health and medical visits. With RPM, the provider can view monitoring device data (like blood sugar levels) as well as compliance with prescription drugs. While not all exams can happen from afar, many do not require an in-person visit.⁵

6 Telehealth Billing Best Practices

If you offer telehealth to patients, consider these healthcare billing best practices:

1. Verify insurance coverage

Insurance guidelines dictate what is and isn’t allowed by providers and patients during telehealth visits. Many private insurance companies now pay for telehealth visits, and Medicaid coverage may vary by state.⁶ Medicare also pays for many telehealth services.⁶ You may want to verify that the patient’s insurance covers telehealth visits before the first appointment.

2. Stay up to date with policy changes

Federal and state regulations influence who can access telemedicine services and when. Before the COVID-19 pandemic, for example, Medicare patients could only receive telehealth services if they lived in a rural area (with some exceptions), and they had to travel to an approved originating site such as a medical facility.⁷ But the government relaxed those restrictions during the pandemic and has since extended flexibilities for telehealth coverage in Medicare through March 31, 2025.⁸ Proposed legislation may extend that coverage through December 31, 2026.⁹

In addition, most states now have a private-payer policy requiring comparable coverage and/or reimbursement for telehealth visits as for in-person visits.¹⁰ Knowing the rules for each payment scenario can help ensure a smooth patient financial experience.

3. Develop helpful patient resources

Consider creating resources for telemedicine services that help patients understand what to expect and how billing works. For instance, you could provide patients with a short guide or video that details how to log on to telehealth calls and offers tech support.

4. Offer flexible payment options

By offering flexible financing options for in-person and virtual visits, patients may find it easier to fit care into their budgets. For example, the CareCredit health and wellness credit card offers patients a flexible way to pay over time for many types of care.* CareCredit can also help you improve the patient payment process with a seamless financing experience, whether online, by mobile app, via in-office device or by phone.

5. Gather patient feedback

Consider making it easy for patients to provide feedback about their telehealth experience (both in terms of their care and the telemedicine billing process) with patient surveys as well as a suggestion box. Once you gather feedback, consider using it to make adjustments to improve your billing process.

6. Include the correct telemedicine billing codes

To help ensure timely and accurate payments, it’s important to include the correct telehealth codes in each bill. Document the patient’s diagnosis, the service(s) provided and the amount of time spent with the provider. Don’t forget to note the correct place of service, whether in the patient’s home or another remote location. The documentation provided must support the codes listed, so ensure your biller is aware of the latest telemedicine coding guidelines. After all, the codes you use determine the payment rendered.¹¹

Important Questions to Ask Payers

If you offer telehealth, you may want to keep these two key questions top of mind:

1. Which healthcare services and providers qualify for telehealth coverage?

It’s helpful for patients and providers to understand that insurance companies may place limits on payments for virtual visits — or they may not pay for them at all.¹⁰ These telehealth coverage policies could impact how much a patient is responsible for paying. While many provider-patient interactions can be accomplished virtually, others require in-person exams.¹² Understanding these differences can eliminate wasted time and set appropriate expectations for both provider and patient.

Even though telehealth is a viable solution for patients who live in remote parts of the country as well as those who struggle to make time for visits, insurance companies may require patients to meet certain conditions (including having an established relationship with a provider or health system) before they’re eligible for telehealth coverage. At the very least, some insurance companies may require patients to sign an informed consent document that addresses the virtual nature of these appointments.¹⁰

2. What types of telehealth technologies are covered?

Synchronous telehealth services are covered by Medicaid in every state, but reimbursement for other types of telemedicine services varies.¹⁰ Thirty-one state Medicaid programs reimburse for four types of telehealth technologies: live video, store-and-forward, remote patient monitoring and audio-only.¹⁰ Medicare patients may also be covered for those four types of telehealth services.⁷ For patients with private insurance, insurers typically can’t require the use of any specific technology or telemedicine platform as a condition for reimbursement.¹³

Knowing which types of visits are covered may help the patient and provider develop a care plan that addresses the patient’s needs, while also ensuring the patient can afford care. Whether or not a telehealth visit is covered, health providers can provide flexible financing options so patients can pay for care over time.

The Bottom Line

Telehealth appointments may offer both time and cost savings for health systems, providers and patients. They can improve provider-patient relationships and eliminate some of the major hurdles that get in the way of patients seeking the care they need and want.³

For a smooth virtual healthcare process from start to finish, consider regularly assessing your patient payments process. Patience, flexibility and clear communication can help ensure you properly take care of your patients while you improve your financial performance.

A Patient Financing Solution for Health and Wellness Providers

If you are looking for a way to connect your patients with flexible financing that empowers them to pay for the care they want and need, consider offering CareCredit as a financing solution. CareCredit allows cardholders to pay for out-of-pocket health and wellness expenses over time while helping enhance the payments process for your practice or business.

When you accept CareCredit, patients can see if they prequalify with no impact to their score, and those who apply, if approved, can take advantage of special financing on qualifying purchases.* Additionally, your practice or business will be paid directly within two business days.

Learn more about the CareCredit credit card as a patient financing solution or start the provider enrollment process by filling out this form.

Author Bio

Lee Huffman is a former financial planner and corporate finance manager who now writes about early retirement, credit cards, travel, insurance and other personal finance topics. He enjoys showing people how to travel more, spend less and live better.

Robyn Tellefsen is a freelance writer and editor with more than 20 years of experience covering health and wellness, finance and more. Her work has appeared on sites such as LoopNet, Beachside Rehab, First Horizon Bank, SoFi, A Place for Mom, American Express, Chase and more.

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