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The new issue of the American Medical Association’s *American Medical
News* includes an article: “How to get paid for care delivered over the
phone” by Victoria Stagg Elliott.It is possible to get paid for your work on the phone.
It takes the right coding for the right situations, the right
documentation and persistence.Some research has indicated that 20% or more of the clinical services
provided in some specialties are done over the phone.But most of the time spent on the phone with patients cannot be
reimbursed, because it is considered part of a face-to-face visit, the
call is short, or the insurer doesn’t cover it.“These services have very specific guidelines in order to bill for
them,” said Betsy Nicoletti, author of The Field Guide to Physician Coding.Insurers increasingly are willing to pay for e-mail consultations, but
physicians who deliver care by telephone say voice communication offers
better patient care.For instance, a billable call can be initiated only by an established
patient or the patient’s guardian.In addition, the conversation cannot be related to a face-to-face
appointment that occurred within the past week or will happen within the
next 24 hours or the next earliest available appointment.In other words, the call has to substitute for in-office care.
The relevant codes are:
* 99441: Five to ten minutes of medical discussion.
* 99442: 11 to 20 minutes of medical discussion.
* 99443: 21 to 30 minutes of medical discussion.* 98966, 98967 and 98968: The comparable codes for care provided by
other health professionals.To increase the likelihood of payment, the call must be documented like
an in-person visit, with particular notation of the time spent.In addition, experts advocate spelling out in contracts with insurers
that such services will be covered.If an insurer does not cover phone calls, it may be possible to bill
patients separately.Most insurers allow patients to be billed for medically necessary
noncovered services.Most medical societies, including the American Medical Association,
support payment for medically necessary care provided by telephone.
