decisionhealth Newsletters, Part B News - 2018 Issue 4 (April)
As telehealth payments climb, OIG finds widespread billing errors
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Article Overview
This piece explains why telehealth billing compliance has become a concern for practices expanding video-based care. It summarizes findings from an OIG audit, reviews Medicare’s geographic and originating-site requirements, and highlights workflow steps that billing teams and compliance staff may use to monitor telehealth claims. The article also notes selected policy changes tied to telehealth expansion under Medicare and Medicare Advantage.
Why This Topic Matters
Telehealth volume is rising, and billing teams need to understand the Medicare coverage framework and documentation expectations that affect claim payment. The article is relevant to practices, compliance staff, and revenue cycle teams trying to reduce avoidable telehealth claim denials or post-payment issues.
Article Sections
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OIG audit findings and telehealth claim errors
Summarizes the audit context, the scope of reviewed claims, and the types of compliance problems identified in telehealth billing under Medicare.
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3 tips to get telehealth claims right
Outlines general operational approaches for improving telehealth claim accuracy, including site verification and internal review processes.
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Budget bill advances telehealth options
Reviews selected legislative and policy developments that expand telehealth availability in future Medicare-related settings.
What You Will Learn
- How a Medicare telehealth audit framed common billing compliance issues
- Which general Medicare telehealth site requirements are emphasized in the article
- How billing workflows can incorporate telehealth claim review steps
- What broad telehealth policy changes are described for future years
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Revenue cycle teams
- Telehealth program administrators
- Healthcare attorneys
Codes Discussed
Modifiers Discussed
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