“Doing Twice the Work for 60% of the Pay”

COVID 19 has touched each part of our lives, none more so than medical practices. I have been following my medical administrative list serve groups and I am now reading about practices closing and laying off employees.  Doctors are adapting by doing telehealth, but this has proven difficult due to the billing rules and regulations changing daily. Additionally, the reimbursement is a fraction of what is normally paid for an office visit.

This title sums up the medical practice world today:  “Doctors worried about survival of their medical practices: ‘This could be the death blow,’ says physician”. “Since the coronavirus outbreak began, the medical practice has seen patient visits drop to 20% of its regular workload.”

Not only are medical practices facing revenue shortfalls, but since elective surgeries have been stopped Surgery Centers have been forced to closed their doors and lay off employees.

Medical facilities are often working on a thin margin in good times. By now, the payments from their February appointments have come in and their March postings will be significantly less, depending on their ability to turn in person visits into telehealth visits, while navigating the numerous changes to the process.

Why is telehealth so difficult to set up? It has to do with the original rules. Telehealth was designed to assist with patients in rural communities that might not have access to specialists. The patient would go to a clinic, the clinic would connect the patient with a specialist and then the patient and specialist or other medical professional would discuss the issue. The provider would create an assessment and treatment plan that would be done at the local clinical site. Telehealth was never intended to be done at home with Skype. Due to the rules, most, if any telehealth, was done by mental health professionals, clinic to clinic.

Now, practices have to scramble to create telehealth platforms, learn the new rules for coding and billing, and create appointment protocols while trying to manage their business. In the best of times, a project of this scale would take months to complete and doctors are trying to do it in days.

Those practices that have been able to do the telehealth and bill correctly are now getting their reimbursement and are very disappointed at the payments coming in. What they have discovered is that they did the work without the monetary compensation, or doing twice the work for 60% of the pay.