The pandemic has played a significant role in the evolving telehealth industry; however, it comes with the increased concerns regarding transparency in telehealth reimbursement. Consumers demand private and public insurers to expand telehealth options and upgrade structures for future telehealth reimbursement. The enhanced demand also drives providers to offer more telehealth options to promote customer loyalty and retention. 

CareCredit published a report on “The Payment Cure: How Improving Billing Experiences Impact Patient Loyalty (PYMNTS)” to investigate how payment experiences influence consumers’ loyalty and choices to healthcare providers. The results indicate that 47% of the patients who received healthcare services were unaware of their providers’ affordable payment options. In contrast, only 31% of the patients know about alternative payment methods. The report further revealed; 36 % of the patients paid for the healthcare services using a credit card, and 30% utilized a debit card. Only 9% of the patients utilized third-party payment plans those providers offer. It is important to note here that payment methods offered in medical practices are familiar. But they are complex when offered in behavioral practices. 

Consumers’ Choice for Savings in Telehealth Payment 

Medical Economics’ published report on the telehealth industry revealed that 63% of the patients and consumers choose to meet their healthcare providers in person. But the preferences of 23% of patients changed in the survey when they knew that telehealth appointments would be less costly. 

Another survey report available at the CIGNA Newsroom revealed that a patient or client looking for a non-emergency digital health care visit saves approximately $93. In contrast, a specialist visit can cost $120 less, and an urgent telehealthcare visit can at least cost $141. Telehealth appointments also ensure the least lab tests resulting in savings of around $118. 

Further in behavioral healthcare; employers concerned about the rising healthcare costs found that employees can get care at the most affordable rates that too within a few days rather than waiting for weeks or months. Another report titled “Does Virtual Care Save Money?” issued by CIGNA has discussed the meaning of virtual care for the understanding of employers and how virtual care is the most efficient and cost-effective healthcare available for employees. 

In the direct-to-consumer market; telehealth services are seen as beginning from low-cost texting companies. As a gambit to a population supported by states or research centers and agencies committed to dealing with certain disorders. 

The clarity in Healthcare and Telehealth Costs

The “Payment Cure: How Improving Billing Experiences Impacts Patient Loyalty (PYMNTS)” study also states that transparency in healthcare costs leads to patient loyalty. For instance; when patients are presented with an opportunity to change their practitioners; people who feel as if their current health providers are honest about the healthcare and its related cost prove more loyalty to their practitioners. However, the transparency depicted by insurance agencies is completely another story. The statistics by the PYMNTS study revealed that 47% of the patients/clients are unaware of the healthcare payment plans by providers related to virtual care and telehealth appointments. 

Utilizing a low-cost approach to fulfill consumer demand through offering digital care and telehealth is a long but certain way of assisting telehealth services towards success. 

From the perspective of a healthcare provider, telehealth, especially telebehavioral healthcare, can considerably reduce office and operating expenses. Further fulfilling consumer demand to expand patient education and billing experiences increases patient loyalty and retention. 

Preventing Telehealth Reimbursement Scam

It is important to mention here that professionals and agencies are accountable for telehealth reimbursement coding irrespective of the refund sources. It is held true regarding telehealth employment or looking for direct reimbursement. During a pandemic, several practitioners successfully received telehealth reimbursement from insurers. Many practitioners were denied the reimbursement. To improve the possibility of receiving reimbursement and getting assurity of legal compliance following suggestions are recommended:

Before billing, ask each insurer directly about their preferences in billing, either through video conferencing or telephone-based sessions.

Make sure to clarify the Place of Service (POC) code with billing agents. As insurance companies don’t reimburse if the location code is incorrect. 

Conclusion

Telehealth reimbursement is essential; however, the future belongs to those who offer fully transparent payment information regarding virtual healthcare. The healthcare professionals providing transparent information encourage trust and patient loyalty, resulting in retention.