Wiki Telehealth

[DIVINE50]

I have been reading about Telehealth but am struggling knowing what physician you bill the telehealth under.

We use the telehealth from 6p to 6a 7 days a week.

Do we bill under the telelhospitalists or does the hospitalists review the telehospitialist note ,sign off on it and then we will under our hospitalists?

I have tried to find this answer and it seems vague to me but what I have seen is that the telehospitialist NPI needs to be linked to our hospital so that is making me think we bill under them not under our employed hospitalists.

I have read CMS guidelines but they are not completely clear either.

Any help would be appreciated.

 

[thomas7331]

Telehealth services, like any other professional services performed for hospital inpatient, must be billed under the provider who actually personally performed and documented the work. So your thinking is correct that you will need to bill these under them and not under the hospitalists.

Who will actually bill the claims would depend on your hospital's arrangement with those providers. If the hospital is paying them for their services, then they will need to be credentialed/enrolled with your payers and assign benefits to your organization's tax ID so the that hospital can bill the claims and be reimbursed. But if they are a separate organization and are not being paid by the hospital for this, then their provider group would bill their own claims and be paid directly by the patients' benefit plans. But in either case, the claims must be billed under the credentials of the individual provider who performed the service.