Some providers have been reluctant to utilize telehealth for optometry services in the past. However, the healthcare landscape is quickly changing and it is becoming more important for optometrists to offer telehealth services to their patients. In fact, the American Optometric Association (AOA) has declared its support for the appropriate use of eye and vision telehealth services. Currently, telehealth services are being offered to those who are unable to see their optometrists in-office for a variety of reasons, including the need to stay home during the COVID-19 pandemic.
In response to social distancing guidelines and stay-at-home orders, both the government and private insurance payers are changing their requirements for optometry telehealth services. This includes the temporary relaxation of some rules to give more people access to virtual care. For example, some practices were unable to provide telehealth services due to requirements for technology. With those requirements relaxed, those practices are now able to offer telemedicine to patients.
Rules from the federal government, as well as payers, are changing on a daily basis. And because the changing guidelines are opening up these services to more people, it’s a new process for many practices. That’s why Applied Vision System is here to help in any way we can as you implement telehealth in your own practice or organization.
Benefits of Telehealth for Optometry
Using telehealth for optometry services is beneficial to patients and providers. Patients have access to the care they would not otherwise get. Providers are able to continue seeing patients when in-person appointments are not possible. This allows physicians and other healthcare providers to maintain the standard of care they have set with their patients while also keeping the revenue cycle going.
Scope of Optometry Telehealth Services
The standard of care provided must remain the same whether services are provided in-person or remotely via telehealth. Telehealth services can be utilized by optometrists in three main areas: evaluation and management, interprofessional consultation, and virtual check-ins.
Evaluation & Management/Medical Visit
Physician-patient encounters that are similar to an in-office medical visit. These services include getting a medical history and performing an examination. Providers may be able to make a diagnosis and prescribe treatment in some cases.
Interprofessional Consultation
Assessment or management by a consulting provider performed via telehealth services (telephone, internet, EHR). This includes a written or verbal report to the physician or healthcare provider who requested the consult.
Virtual Check-In
Brief communications with established patients done through telehealth services. These check-ins are usually initiated by the patient and can be used to avoid trips to the provider’s office. To qualify as a check-in under CMS rules, this service cannot be related to a medical visit (in-person or via telehealth) within the last 7 days or lead to a medical visit within the next 24 hours.
Optometry Telehealth Billing
Medicare and third-party insurers provide reimbursement for these visits the same way they would if the services were provided in-person. The codes for optometry services just need to have the modifier code 02 for telehealth to the appropriate examination code.
Coding for telehealth needs to adhere to the same rules as in-person visits to determine what code is used. The level of service provided and the time spent with the patient are still key components in determining how to code and bill for telehealth services.
It’s important to keep in mind that telehealth is currently a moving target. Rules from the federal government, as well as payers, are changing on a daily basis. Staying up-to-date on those rules can be difficult for individuals to manage. That’s where Applied Vision Systems comes in. Our experienced billing team will work to ensure that you get proper reimbursement.
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Having a qualified medical billing team on your side can help your optometry practice make the most of your telehealth services. Applied Vision Systems uses technology-driven optometry billing services (change to URL for vision site) to efficiently and correctly process claims for in-person and telehealth services.
To talk to an AVS team member about how our solutions & services can benefit your practice, call us at (919) 477-5152 (unless vision will have a separate number).
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