The OIG recently reported that 96% of SC Medicaid telehealth visits paid in error. The findings highlight the need for provider education, especially as reliance on telemedicine skyrockets during the COVID-19 public health emergency.
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The OIG reviewed 100 South Carolina Medicaid fee-for-service telemedicine payments between July 1, 2014, and June 30, 2017, finding only three met Federal and State requirements. Substantially all of the errors related to technical deficiencies where the practitioner did not:
With so many providers using telehealth for the first time in response to state lockdowns and other social distancing protocols, mistakes are bound to occur. Suppliers must monitor for these oversights and educate referring providers on proper telehealth documentation to avoid significant recoupments. Suppliers should:
SOURCE LINKS
https://oig.hhs.gov/reports-and-publications/oas/cms.asp
https://oig.hhs.gov/reports-and-publications/workplan/index.asp
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The OIG reviewed 100 South Carolina Medicaid fee-for-service telemedicine payments between July 1, 2014, and June 30, 2017, finding only three met Federal and State requirements. Substantially all of the errors related to technical deficiencies where the practitioner did not:
- Log start and stop times, and/or
- Identify the consulting site location.
With so many providers using telehealth for the first time in response to state lockdowns and other social distancing protocols, mistakes are bound to occur. Suppliers must monitor for these oversights and educate referring providers on proper telehealth documentation to avoid significant recoupments. Suppliers should:
- Familiarize themselves with all federal, state, and other third-party contractual rules related to telemedicine visit substantiation and reimbursement.
- Create a standard intake checklist to monitor referring providers’ telehealth documentation used to support DME orders, including:
- Documentation of start and stop times, and
- Despite COVID-19 related removal of site restrictions, descriptions of the patient and practitioner’s locations during the telemedicine visit.
- Provide education to referral sources with documentation errors.
SOURCE LINKS
https://oig.hhs.gov/reports-and-publications/oas/cms.asp
https://oig.hhs.gov/reports-and-publications/workplan/index.asp
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