![]() ![]() What conditions/types of patients are you treating? If you have a large amount of chronic care patients or ones you have regular visits with (therapy, dietary counseling, etc), a subscription or monthly plan might work best. ![]() Given all this, how do you decide the pay rate for your telemedicine appointments? Here are a few considerations to think about when determining what you are going to charge: Stanford Children’s Health and Stanford Health Care, both in Palo Alto, Calif., charge $700 for its Grand Rounds program, which offers digital second opinion consultations from Stanford physicians.McLaren Health Care in Grand Blanc, Mich., charges $49.Summa Health in Akron, Ohio, charges $30.Walmart offers its employees $4 telehealth appointments.Doctor on Demand and Humana’s health plan On Hand charges $0 to $5.However, Becker’s Hospital Review just published an article reviewing 7 vastly different price profiles for video visits: Medicare pays around $50 per visit on average, and, in the way of large commercial services, Teladoc charges $45, AmWell $69, eVisit $60, and Doctor on Demand $38. While we are all aware of the intricacies of reimbursement for telemedicine, what if your payment model doesn’t include billing insurances at all for your virtual visits? When your patients are paying out-of-pocket only, it changes the game – it removes the snags that insurers can often create in your quest to get paid, but it also introduces a new set of questions:Īccording to recent surveys, out-of-pocket telemedicine visits are an average of $30-75 nationally, with most visits at around $40-50. In all cases, be sure to have a notice of payment practices reviewed and signed by your patient before conducting any telemedicine appointments.īilling your video visits directly to your patient can be well worth the time it takes to answer these questions for yourself – removing the headache of dealing with commercial insurers and state reimbursement policies is incentive enough for most practices who choose this route.If your patient’s insurance does not cover video visits, you may bill them for the entire charge.Conversely, you can also bill their insurance, accept whatever payment they submit, and then bill your patient for the balance (provided the patient is aware that they will receive that bill.) If you are not contracted with the patient’s insurance (out-of-network), you may charge them the full fee at the time of service and they can be reimbursed for whatever out-of-network benefits they have.If you are contracted with a patient’s insurance (in-network), and they cover live video telemedicine, you must accept what they state the fee is (copay + insurance payment) and you must waive the remainder (the “balance”) – you cannot bill the patient for it.Your charge-per-visit can be whatever you choose.If you are billing out-of-pocket for some patients and to insurance for others, you need to keep in mind the Balance Billing law first and foremost. If you are trying to decide where on that spectrum your practice will fall, here is a helpful primer on navigating that decision. Innovative providers are deciding not to wait for the industry to catch up by offering video visits out-of-pocket…either as the only payment option, or in conjunction with reimbursable services. The emergence of telehealth technology has created a cloud of uncertainty on the economy of care. Confusion over reimbursement policies for telemedicine appointments contributes to slow adoption among healthcare providers around the county.
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