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Some Insurers Balk at Covering TeleHealth Visits

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Telehealth is booming as the pandemic prompts more patients to skip the waiting room. (Adobe Stock)
Telehealth is booming as the pandemic prompts more patients to skip the waiting room. (Adobe Stock)
December 28, 2020

LITTLE ROCK, Ark. -- Telehealth visits have jumped nationwide since the onset of the pandemic. Between mid-March and mid-June, an estimated 9 million Medicare recipients relied on Telemedicine.

Data show among private insurers, telehealth visit claims increased by more than 4,000%. But now providers are pulling back from covering non-COVID-related virtual visits, and costs for patients are increasingly muddled. Some could even end up with surprise medical bills.

Tom Conroy, CEO of the health care technology company MedSign, explained why.

"They do not have safeguards. There's no safeguards in the system where they can actually tell if a Telehealth session occurred officially," Conroy said. "Last year in Florida there was fraudulent charges for Telehealth to the order of $1.2 billion. And the reason is, there's no controls in the system."

But denying access to Telehealth coverage could have major repercussions for rural states such as Arkansas, where transportation continues to be a barrier for patients seeking care, and where hospitals and providers have relied on Telehealth payments to stay afloat during the pandemic.

Conroy added in the long run, covering Telehealth visits could save the government Medicare dollars by encouraging preventive care.

"Seniors use 75% - 80% of all Medicare dollars," he said. "One of the reasons why is they go into the hospital, the minute they step over the emergency room doorway, it's $3,000. If they stay inside of hospital either in New York or in California, in Los Angeles, it's $17,000 a day. Extraordinary costs."

The American Medical Association and several lawmakers have voiced support for legislation that would increase access to telemedicine from all types of providers, as well as ensure Medicare coverage for virtual visits.

Nadia Ramlagan, Public News Service - AR