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One opportunity that will exist for ARNP’s will be if Bill H.R. 4040 passes; it ensures federally qualified health centers and rural health clinics can provide telehealth services under the Medicare program beyond COVID-19. ARNP’s could educate and influence policy and policymakers to regulate this at state and local levels (H.R. 4040 117 Congress, 2021).
Bill H.R. 4040 ensures that Americans will use telehealth services even after the emergency declaration is ended. COVID-19 posed significant obstacles, including providing a secure atmosphere where our elderly could receive high-quality health care. Thankfully, Congress was able to remove many of the restrictions that kept seniors from accessing telehealth services from the comfort and security of their own homes. Telehealth use among seniors has continued to climb, and this bill would ensure that this successful trend continues long after the pandemic is over by permanently reducing unnecessary red tape (Chaney, 2021).
Another opportunity would allow rural providers, such as ARNP’S, to assist patients remotely while adequately reimbursed for their efforts. Telehealth coverage at Federally Qualified Health Centers (FQHC) and Rural Health Clinics would be made permanent under Bill H.R. 4040.
Challenges that exist with in-person health care are prone to misdiagnosis, but telehealth raises the stakes. Add in the fact that state legislators have yet to create a defined standard of care, and quality may vary from one provider to the next.
Another challenge is compensation and coverage for telemedicine services equal to in-person services, a significant obstacle for telehealth. Payment parity between telemedicine and in-person health care is not guaranteed. Even in the 28 states where payment parity rules have been enacted, there is no system to implement them (UIC, 2020).
This is where the ARNP policymakers step in, using their expertise to help design an effective business strategy to assist with an accurate diagnosis, such as determining your symptoms and then making a therapy recommendation, arranging for imaging tests, such as MRIs to help with their diagnosis. They can also send an electronic referral to a physical therapy facility or a prescription to your pharmacy.
Hopefully, we’ll soon arrive at where all payers have clear criteria for charging telemedicine. Medical billers, on the other hand, require immediate answers to their billing and coding questions. What should I charge for telemedicine? What are the best codes to use? How is telemedicine remunerated? What are the limitations I should be aware of (Lafolla, n.d.)? Proper billing and coding rules for reimbursement coverage will guarantee payment for certain telehealth visits, like diabetes or COPD, etc. We need to get to the point where all telehealth has clear billing criteria.
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