The Curious Case for Telehealth: HeadingTo Cover or Not to Cover?

Doctor’s appointments have taken a new form in recent years—they have gone digital!

Instead of you walking into your doctor’s office (or they ringing your doorbell for a house call), your doctor now pings your smartphone.

Yes, with telehealth, care comes to you, wherever you are, with just a click!

Telehealth is more essential than ever, driven by the changing lifestyle and the desire to overcome geographic limitations. Yet, despite its growing value, concerns around its sanctity and effectiveness are sparking debate, leading to deliberation and uncertainty around its continued coverage.

Let’s break down what’s been happening with telehealth coverage of late and how it all started.

The History

While the world might attribute the COVID-19 fallout for telehealth adoption, its history can be traced back to the early 1900s.

There is no denying, however, that the pandemic was a catalyst that turbocharged virtual health consultation overnight.

The COVID-19 Public Health Emergency

Before the pandemic

Medicare paid for telehealth services under specific criteria, including:
After the pandemic
The pandemic necessitated a policy change, eliminating several barriers for the larger good of patients, ushering in an era of accessible care for all through telehealth. The most significant of these flexibilities offered were:
  • Removal of Geographic and Site Restrictions

    Before COVID-19, Medicare only covered telehealth for patients in rural areas, and they had to access it from approved healthcare sites (like clinics and hospitals). During the PHE, telehealth services were allowed from any geographic location (urban, rural, suburban) and could be delivered to patients at home.

  • Expansion of Covered Services

    The list of services eligible for telehealth coverage was significantly expanded, including mental health services, physical and occupational therapy, and certain emergency department visits, making telehealth applicable across a broader range of healthcare needs.

  • Allowance of Audio-Only Telehealth Services

    Medicare allowed audio-only (phone) consultations for patients who lacked access to video-enabled devices or the internet, ensuring that underserved populations could still receive care remotely.

  • Increased Provider Eligibility

    More types of providers, such as therapists, clinical social workers, and speech-language pathologists, were allowed to deliver telehealth services. Previously, only certain providers, like physicians and nurse practitioners, were eligible.

  • Payment Parity for Telehealth and In-Person Visits

    During the PHE, telehealth visits were reimbursed at the same rate as in-person visits, encouraging widespread adoption and ensuring providers weren’t financially penalized for offering virtual care.

How the Pandemic Rewrote the Telehealth Narrative

A 78-Fold Leap

Telehealth usage was 78 times higher in April 2020 than in February 2020

56% jump in hospitals offering telemedicine services, from 46% in 2017 to 72% in 2021

75% increase in telehealth encounters, from 111.4 million in 2020 to nearly 194.4 million in 2021

Why the Uncertainty?

All these five flexibilities are on borrowed time. While they will continue to be offered through the end of 2025, their fate beyond that remains uncertain unless further regulatory or legislative actions are taken. This brings us to the heart of the matter: what are some of the most pressing concerns surrounding telehealth today?
  • Fraud, Misuse, and Financial Concerns

    Telehealth has raised concerns about the potential for fraudulent billing and unnecessary visits, which can drive costs and create inefficiencies, prompting calls for tighter regulations and controls.

  • Clinical Effectiveness Limitations

    Certain medical services like chronic care management may not be as effective when delivered virtually. The lack of direct interaction with patients can hinder accurate diagnoses and the quality of treatment for complex conditions.

  • Equity and Accessibility Barriers

    Telehealth’s reliance on technology and internet connectivity can leave vulnerable populations—like those in rural areas, the elderly, or low-income individuals—disadvantaged, creating a digital divide hindering access to the same level of care as others.

  • Privacy, Security, and Care Gaps

    Non-compliant platforms raise concerns over data privacy and security risks, while virtual care may lead to fragmented care, making it harder to coordinate treatments and maintain continuity across providers.

  • Provider Challenges

    Telehealth may weaken the patient-provider relationship, reducing face-to-face interactions crucial for trust and effective care. Providers also face burnout due to the constant juggling of virtual and in-person visits, which may create inefficiencies in care delivery.

What Should Healthcare Practices and Providers Do Right Now?

How Jindal Healthcare Is Leading the Charge

At Jindal Healthcare, we are committed to empowering healthcare providers to embrace telehealth seamlessly and effortlessly with our robust revenue cycle optimization solution suite.

Combining industry expertise with the power of the 3As of automation, artificial intelligence, and analytics, we help providers confidently navigate and realize the potential of telehealth while helping them:

Make patient access seamless with
automation-led patient verification
and SOP-guided documentation
for quick payer approvals

Navigate coding and
billing with ease
with experts performing claim
scrubbing and ensuring timely
claim submissions

Maximize revenue capture with AI-prioritized claims, decision tree-guided resolution, and root cause analysis and feedback-driven denial prevention
Make patient access seamless with automation-led patient verification and SOP-guided documentation for quick payer approvals

Navigate coding and
billing with ease
with experts performing claim
scrubbing and ensuring timely
claim submissions

Maximize revenue capture with AI-prioritized claims, decision tree-guided resolution, and root cause analysis and feedback-driven denial prevention

Transforming Healthcare with Measurable Impact

50%

Reduction in
RCM Costs

35%

Increase in
Average Revenue

60%

Reduction in 90+
Days Aging

Maximize Your ROI on Telehealth RCM

Partner with Jindal Healthcare and let our experts help you build the financial resilience you need to bridge the care gaps through efficient telehealth.

To explore our full suite of AI-powered RCM solutions, visit www.jindalhc.com.