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Telemedicine for Follow-up Care

Doctor on Phone (cropped)Follow-up care is a central component of any care plan; it is also vital to the economics of outpatient practices.

Initial visits are generally of higher complexity and therefore more time consuming. Where follow-up appointments are usually short and routine visits that provide practices with nearly the same amount of revenue but with much less time dedicated to the appointment. Unfortunately in most cases, the increase in time and resources spent on a higher complexity appointment is generally not off-set by a proportional increase in reimbursement. Think about the following example:

An established patient comes into the office exhibiting exacerbation of a chronic condition. After the physician does a comprehensive history and physical exam she orders cardiovascular imaging and adjusts medication for hypertension – billing CPT code 99215 reimbursing at about $142. This visit took the better part of an hour.

On the other hand, imagine the practice is able to see four patients for routine follow-up care in that same hour. A simple medication adjustment or a 10 minute conversation to go over some slightly abnormal lab results. Those visits (generally level 3 office visits) reimburse at about $70. So the practice made $280 in that hour, nearly twice the amount received for the higher complexity visit. The strain on office resources was likely lower as well – it is easier to accommodate lower acuity visits.

It’s easy to see that from the standpoint of practice economics, routine follow-up care is extremely important. But of course there are some drawbacks to focusing on these types of appointments. For instance, follow-up appointments have much higher no-show rates than initial visits, the impact of which we explored here.

Another obstacle with follow-up visits is that patients are often resistant to coming back in for what amounts to a ten minute conversation about some slightly abnormal lab results. In these cases, providers are resigned to phone calls or even letting the follow-up consult fall by the wayside.

What if there was a way to offer the convenience of the phone call and still be reimbursed for the routine follow-ups that are so vital to the economics of your practice? Enter telemedicine for follow-up care. Whether you make patients come back into the office, or you call them over the phone, those types of visits that do not require a physical exam can now be done via secure video visit.

For the patient’s part, their normal co-pay applies, and their insurance will generally cover the visit just as if they had come into the office. Given the choice, most patients prefer the convenience of seeing their physician from their home or office.

So what should you look for in a telemedicine platform? First of all, since this will replace certain types of in-office follow-up appointments, integration with your existing EHR is critical. You should be able to schedule the appointments in your existing system as you normally would. Second, you should be confident that you will be reimbursed. Chiron Health clients can leverage a unique telemedicine insurance rules engine to determine which payers will cover telemedicine, and how to be reimbursed for the follow-up care that is so vital to your practice.

Chiron Health makes it easy for practices to convert unpaid follow-up calls to fully reimbursed video visits. Schedule a demo today to learn more.