There is reason to believe that soon, every patient with any type of insurance coverage will be eligible for telehealth coverage. We aren’t there yet, as state regulations and payer policies still vary from state to state and insurance company to insurance company.
Fortunately, your patients with coverage through Humana don’t have to wait for that day. Humana has joined the other largest insurers in offering coverage for certain types of telemedicine, including video visits.
Thirty states have laws that require private insurers to reimburse healthcare providers for encounters conducted with specific types of telemedicine. Even more states are poised to do so in the near future. Humana is included in these requirements for most commercial plans. (Some states allow small group plans to opt out of telemedicine coverage.) Many states require that telemedicine be reimbursed on par with in-person visits, while others leave the reimbursement amounts up to the payer.
Each state has made its own determination about what types of telemedicine will be covered, but everyone with a telehealth parity law covers live video visits. Some also cover store-and-forward telemedicine.
Humana believes that technology is transforming healthcare just as it has transformed everything else. They understand that new telecommunications technologies have great potential to improve access to care and result in better health outcomes, while at the same time lowering costs. Humana has embraced both eVisits and remote patient monitoring. Along with Blue Cross Blue Shield and United Health, Humana will reimburse healthcare providers for remote visits with patients on most plans even in states that don’t require them to do so.
The Humana website explains, “Physician-to-patient telemedicine experiences aren’t meant to replace in-person visits. But they certainly have the potential to be an important means for diagnosing routine ailments, providing follow-up care and managing chronic disease.” Early this year, Humana even extended telemedicine coverage to its Medicare Advantage plans in certain states.
“In a world that’s increasingly mobile, more connected and in need of lower-cost alternatives for non-emergent care, telemedicine’s time has come. The convergence of technology and societal needs is driving consumer readiness for these real-time, video-based doctor visits,” wrote Elizabeth Bierbower, Humana’s Employer Group Segment President. “This flexibility is one reason we’ve embraced telemedicine services at Humana. Telemedicine is part of our integrated care delivery model that brings together delivery and management of healthcare services where and when patients/members need it.”
Although Humana is a friend to telemedicine, it is still necessary to validate coverage for each visit. In order to make it a piece of cake to determine if your Humana and other patients are eligible for telehealth reimbursement, Chiron Health has developed the most advanced technology for eligibility verification in the market. The Chiron Health Rules Engine® is constantly updated by our team of coverage experts with the latest information. When a remote visit is scheduled, the Rules Engine gets the patient’s insurance coverage details from your EHR and automatically determines whether telemedicine will be covered.
We know that the Chiron Rules Engine® is sufficient for eligibility certification most of the time, but we also know that sometimes more complicated situations come up that require a bit more hands-on effort. That’s why we have a dedicated team of experienced claims experts who will help you and your staff with the complicated cases.
There’s no reason for your team to waste time on the phone with Humana hammering out a reimbursement issue. We’ve processed thousands of visits and have probably solved a similar challenge. We’re happy to share our expertise.
We’re so certain that our Rules Engine will accurately determine eligibility for Humana patients and those with similar coverage, that we guarantee the accuracy of our verification. If a claim for a video visit that we validated is ever rejected, we will work with Humana to resolve the issue.
If we can’t, we’ll pay you for the visit ourselves. How can we be so sure? It’s because The Chiron Rules Engine® along with our team gets smarter with every eligibility check we perform.
Humana is out front when it comes to improving patient health and keeping costs low by reimbursing for telemedicine. Still, plans do vary, so it is a good call to choose a telehealth solution that can quickly and easily validate coverage for your Humana patients. Telemedicine represents a big opportunity for your practice and your patients so why wait?