To provide telehealth services, Medicare Advantage (MA) plans must advise each enrollee that they may receive certain Medicare Part B services through “electronic exchanges[1]”. Electronic information or telecommunication technologies such as secure messaging, telephone, videoconferencing, and other evolving technologies capable of non-face-to-face communication expand the care options of MA plans. At the enrollee’s discretion, MA plans must still provide in-person access for the Part B service specified by the provider. And the plans must still comply with provider selection, state licensure, and credentialing requirements.[2] To qualify as an additional telehealth service, however, the service must meet the following requirements:

  • The service is available under Medicare Part B but not payable under the original Medicare telehealth benefit; and[3]
  • Providing the service through an electronic exchange is clinically appropriate when the acting physician is not in the same location as the enrollee.[4]

The experts at Advis will make sure your practice/group is prepared to take advantage of increased telehealth opportunities by:

  • Performing a detailed market analysis to determine where in your service area telehealth volume can be expected to increase;
  • Reviewing your infrastructure capabilities to ensure that you are equipped to handle increased telehealth demand;
  • Assisting with determining whether your organization will be deemed an MA qualified provider; and
  • Providing innovative strategies for attracting new contracts with additional MA plans.

To learn how to better maximize your telehealth reimbursement potential, please click here.

Contact Advis for more information or call our offices at (708) 478-7030.

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[1] 84 Fed, Reg. at 15684.
[2] 42 CFR § 422.135.
[3] Id. at (a)(1).
[4] Id. at (a)(2).