Telenutrition is a hot topic these days. But the logistics of how to report it and get paid are often... fuzzy. We hope this guide helps clarify some of the details.
Eligibility Checks for Telenutrition
The telenutrition benefit varies widely, not only by insurance company, but by individual plans. To get telenutrition paid by insurance it's critical that you do a full eligibility and benefits check prior to seeing the patient.
The current reality of telehealth is that it's more likely to be rejected when you file claims with insurance companies. This is improving, but be prepared to appeal an incorrect denial: the best defense is a comprehensive benefits check with a reference number that you can cite later.
If you're completing these checks on your own, be certain to tell the agent that you plan to perform the services electronically. They may ask you for your telenutrition originating site. This is the location where you will be at the time of service.
- Eligibility and benefits checks are highly recommended for telenutrition
- If you use Healthy Bytes for eligibility checks: Make sure your customer service rep knows to check for telehealth benefits
- If you're seeing patients across state lines you'll need to check the rules in both states.
The Telenutrition Appointment
Not all clients are tech savvy, which can lead to unexpected hiccups during your appointment. If you're using a video telehealth platform, confirm that your client:
- Has internet access,
- Is on a device that meets the minimum requirements your platform,
- And understands how to login.
The platform you're using will likely have good docs you can give to your patients to help them get set up.
Set your Environment
Beyond having a good platform, you need to additionally set the stage so that your patient will be able to see and hear you properly.
- Use a high quality mic
- Position your camera to be eye level
- Check your lighting. Make sure you're not too bright or too dark for the patient to see (we recommend testing with a 'test appointment' beforehand)
- Make sure your office is quiet
Look for subtle communication cues
It's easy to lose engagement with a client during a virtual appointment. You need to focus more even more on rapport building for it to translate across a virtual platform. It's tempting to look up information or scan their food diaries while chatting, but this can cause a client to disengage. Try to maintain eye contact with your client and focus on their facial expressions. This will help keep you both engaged.
- Identify and fix technology issues prior to the appointment
- Set the environment to be quiet and well lit
- Focus more on facial expressions and make eye contact during the appointment
Filing a telenutrition claim
Individual insurance companies have different preferences on how telenutrition claims should be filed. Check your provider handbook for full details. In general, you'll file your claims normally with the location as the place where you were located (e.g., office- code 11) and the procedure code set as usual. You'll generally need to use a modifier to indicate the telehealth visit.
UPDATED: As of 1/1/17 CMS added a new location code. You can now file telehealth claims using location code 02.
- GQ- Via Asynchronous Telecommunications systems
- GT- Via Interactive Audio and Video Telecommunications systems
We'll be profiling exciting new telenutrition platforms in the coming weeks. Stay tuned!