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OrHIMA 2020 Virtual Annual Meeting – Revenue Enhancement Through Patient Care Improvement During and After the Public Health Emergency

Through the 1135 Waiver authority, CMS waived certain telehealth requirements that have long presented a barrier to utilization and expansion of telehealth technology in the delivery of healthcare. This waiver was issued in order to limit the community spread of COVID-19 and keep vulnerable patients in their homes while maintaining access to needed routine and screening care. Prior to the Public Health Emergency declaration, the provision of healthcare services through telehealth faced many barriers which included acceptance of the technology by both patients and providers. The regulatory and reimbursement requirements for these services did not encourage and likely is courage implementation of telehealth. Telehealth regulations at both the Federal and state levels have not kept pace with technology. Prior to the COVID-19 outbreak, the American Telehealth Association projected that by 2030 50% of medical consultation would be conducted by virtual means. Many industry experts saw this as an ambitious projection. The changes we are seeing in the midst of this world-wide pandemic will likely serve as a catalyst for spurring not only use of telehealth technology, but acceptance by providers, patients, payers and regulators. Given current economic unknowns, healthcare providers must ensure reimbursement for the services provided and identify those services that best meet the clinical needs of patients while protecting the financial health of their organizations. In this presentation, we discuss not only reimbursement requirements under Waiver services; but, how to use the processes setup during this public health emergency for the financial benefit of healthcare providers.

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