The shift to virtual care isn’t a future trend, it’s a present-day reality. For years, telehealth has been gaining traction, and recent data from the Deloitte Center for Health Solutions shows just how deeply it was becoming embedded in patient behavior even before the major boom of the last few years.
This change in how patients access care is more than a clinical or technological shift, It brings new opportunities for patient engagement but also new complexities for your revenue cycle. A closer look at who is using virtual visits reveals crucial insights for any healthcare practice looking to thrive.
Decoding the Generational Shift to Telehealth
The data reveals that telehealth adoption isn’t limited to one group, from Baby Boomers, Gen X and Millennials to Gen Z, people from all the generations have higher inclination towards virtual visits.
The Millennial and Gen Z Narrative
Unsurprisingly, younger generations show the highest adoption. In 2020, 35% of Gen Z and 31% of Millennials had used a virtual visit in the past year. For these patients, digital access to healthcare is becoming a core expectation.
Digital Adoption of Gen X and Boomers
The most compelling story is the growth among established patient populations. Gen X adoption grew by 7% (from 14% to 21%), and Baby Boomer usage nearly doubled (from 6% to 11%). These groups represent a massive portion of healthcare consumers, and their increasing comfort with virtual platforms is a clear signal that telehealth is here to stay.
A Mixed Picture
Interestingly, the data shows a slight decrease for the senior generation. This highlights a critical point. While technology is being adopted broadly, providers must offer a mix of care options to serve their entire community. Flexibility is key. Given that providers cater to patients from all age groups, it is essential for them to have flexible payment options and digital care models to cater to each generation.
The Billing Challenge: Getting Paid for Virtual Care
While clinics focus on delivering quality care through a screen, a crucial question arises in the back offic. Are we billing for these services correctly?
Telehealth reimbursement is not as simple as billing for an in-office visit. It’s a complex and constantly evolving landscape with specific rules that, if ignored, lead directly to denied claims and lost revenue.
Key complexities include:
Constantly Changing Payer Policies
Rules for what constitutes a payable telehealth service, what is covered, and how much is reimbursed can vary dramatically between Medicare, Medicaid, and commercial insurance plans.
Specific Modifiers and Codes
A telehealth claim requires the correct use of modifiers (like modifier 95 for synchronous telemedicine) and Place of Service (POS) codes (like POS 02 or 10) to be processed correctly. Using the wrong one is a guaranteed denial.
Audio-Only vs. Audio-Visual
Payers have different rules and reimbursement rates for services delivered via a phone call versus a video conference. Knowing the difference is critical for compliance and proper payment.
MBNC: Your Expert Partner in the Telehealth Era
Navigating the complexities of telehealth billing shouldn’t take your focus away from patient care. As a dedicated medical billing and coding partner, MBNC ensures your practice is perfectly positioned to capitalize on the virtual care revolution without sacrificing revenue.
- Our team constantly tracks policy updates from all major payers, so your claims are always compliant with the latest rules.
- Our certified coders are experts in the specific requirements for telehealth billing, ensuring your claims are clean on the first submission.
- We specialize in managing and appealing telehealth-related denials, recovering the revenue you are rightfully owed.
Virtual care is now a permanent part of the healthcare landscape. Make sure your revenue cycle is ready for it, and if it is not, contact us today so you can stay ahead of the curve.
