Regulatory and Reimbursement Analysis
The Reimbursement Analysis identifies the payor, state, federal and medical board requirements for telehealth services. After the completion of this work the client will have the capability to bill appropriately, understand revenue potential and apply performance metrics.
Deliverable: Revenue Cycle Assessment
- Identify telehealth services to be reviewed.
- Define state and federal policies and regulations related to services reimbursement
- Identify state medical board scope of practice guidelines
- Payor contract review for telemedicine reimbursement
- Determine coding requirements
- Identify reimbursement allowances
- Develop revenue projections for service population
- Determine required clinical and financial data components
- Coordination of coding and billing processes for test bill
- Monitoring quality of revenue cycle processing for test bill
- Identify reporting and performance metrics
The TA project can include an additional proforma for estimated ROI for a clinical or operational service.