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Blog | Telemedicine

Major insurers roll back no-cost sharing telehealth services

Blog | Telemedicine

Major insurers roll back no-cost sharing telehealth services

  • Starting Oct. 1, several private health insurers will no longer fully pay for virtual visits under certain circumstances — effectively reinstituting costs for patients reliant on the virtual care that has been heralded as a lifeline at a time when Covid-19 is still killing more than 700 Americans each day, according to STAT News.
  • The article goes on to explain changes to no-cost sharing by both UnitedHealthcare and Anthem for telehealth visits.
  • HFMA’s Chad Mulvany emphasizes that good patient communications upfront is important for providers who will be sending out patient bills after health plans change how they are paying for telehealth.

STAT News is reporting that, "Starting Oct. 1, several private health insurers will no longer fully pay for virtual visits under certain circumstances — effectively reinstituting costs for patients reliant on the virtual care that has been heralded as a lifeline at a time when Covid-19 is still killing more than 700 Americans each day. The insurance giant UnitedHealthcare is ending a 'virtual visit' benefit that had been expanded to many members during the Covid-19 pandemic, through which it was covering the full cost of visits — without any cost to patients — for individuals who were seeing in-network providers virtually for medical issues not related to Covid-19. And Anthem, the company behind a number of affiliated health plans across the country, will stop waiving the cost of copays, coinsurance, and deductibles for virtual visits not related to Covid-19. Beginning Oct. 1, a commercially insured 'member’s cost shares will be applied based on the terms of the plan they purchased,' the spokesperson said, adding that Anthem-affiliated health plans 'have a long history of covering telehealth visits.' The spokesperson did not return STAT's request for details about the coverage changes for different Anthem-affiliated health plans."

Takeaway

This change in telehealth benefits by health plans is a perfect example of why good Patient Financial Communications are important. Many consumers have used telehealth for the first time during the pandemic. And so far, they haven't been charged cost sharing for it. So after a telehealth visit in October, the patient now receives a surprise bill after the fact, and my guess is, they won't be happy.

While it's their health plan or employer's change in benefit design that created the issue, guess who they're likely going to be unhappy with about the unexpected bill? That's right … the provider. So it will be important for clinics to build a step, if it doesn’t already exist, into their telehealth workflows to educate the patient on their cost sharing, enable staff to explain why this has changed and to collect the cost sharing. Otherwise, you risk alienating patients unnecessarily. 

About the Author

Chad Mulvany, FHFMA,

is director, healthcare finance policy, strategy and development, HFMA’s Washington, D.C., office.

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