Karina Ladyhin is President and Founder of KLear Medical Solutions. Karina has worked for doctors and seen them struggle to get paid, inspiring her to start her own medical and dental billing firm. She draws from her wide experience in healthcare to take care of the billing so doctors can take care of the healing. She holds a Bachelors degree in Healthcare Administration from DeVry University. We recently sat down to talk about the challenges of telemedicine billing, staying on top of regulations, and some tips to optimize revenue and ensure the financial health of your practice.
Teledocjobs.com: Can you tell us a little about why you’ve decided to focus on telemedicine?
Karina Ladyhin: I always stay on top of the latest billing news and policies and as soon as the pandemic hit, I knew that telemedicine would be the future. From my own experience, I know how important it is to have a knowledgeable biller and telemedicine presents a whole new challenge in this arena.
TDJ: What are some of the most common billing errors you see physicians make in telemedicine?
KL: Documenting the wrong place of service, not including the correct telemedicine modifier, lack of awareness when a certain payer started covering telemedicine visits, meeting medical necessity, up-coding or under-coding – these are all common errors I see physicians make which can result in lower payments. The increase in revenue that my clients see once the billing and coding is done correctly is tremendous and rewarding – with accurate billing the return rate can be as high as 95%.
TDJ: It seems like the rules regarding billing and telemedicine are changing on a daily basis. How do you keep up?
KL: I’m in constant contact with the insurance companies and spend a lot of time researching the latest government updates. One of the latest updates is billing for telephone patient services. This service is covered by Medicare and most commercial payers in Pennsylvania, New Jersey, Delaware, and Maryland. Furthermore, there are special CPT codes that are required to bill Medicare for this telephone medical discussion. This service could bring value to those patients that do not have access to a smart device which allows video and doctors can also benefit by billing this service for enhanced revenue.
TDJ: Are there any resources you recommend physicians check regularly to stay up to date with all the rule/billing changes?
KL: One great resource that I would recommend is to sign up for Google Alerts. You can create an alert for any topic, such as telemedicine billing, and receive daily or weekly updates to help you to stay on top of the latest regulations.
TDJ: What services does your organization offer?
KL: KLear Medical Solutions is a professional billing service dedicated to meeting all of the insurance and patient billing needs of a medical or dental practice. We offer a variety of highly personalized services that can improve cash flow and lower operating expenses. KLear Medical Solutions carefully balances our client base in order to ensure that each client receives our complete and undivided attention. In addition to premium claims processing and practice management services, we proudly offer the following dynamic solutions:
TDJ: Do you have any advice for practices or practitioners that feel overwhelmed by all of the billing/rule changes?
KL: Take this time to implement new services and procedures into your practice. We all had to change the way we do things and the old normal is no longer standard. Telemedicine will have a lasting impact on medicine which means that there will be new streams of revenue available in medical billing. Make sure you have a strong team of professionals that will help get your business to the next level. I also recommend providing your employees with continuing education courses. This is a great time to do that since there are so many webinars that are available to help healthcare professionals and their employees stay updated with all the changes in billing. A lot of these webinars are even provided for free!
TDJ: Any final advice to help practitioners optimize their billing?
KL: Always verify patient’s eligibility for telemedicine beforehand. Also, make sure to continue to collect co-pays for all telemedicine services not related to COVID-19 testing before the visit. Furthermore, submit your claims on a weekly basis to not get backlogged. Most importantly, remember that the financial health of a practice relies on the competent performance of the medical billers. I believe that doctors should do what they do best and let us take care of the rest!
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