As the COVID-19 crisis spreads, non-essential medical services have been forced to close their doors in most states. Although some states have begun the process of reopening, optometry still faces an uphill battle before the business can return to normal.

For the time being, many optometrists are offering basic telehealth services in order to continue providing prescriptions for contacts and other services. Here is the current situation for optometrists’ billing and business practices.

In-person Visits

When states reopen, optometrists may be able to offer in-person visits at a reduced capacity. There may be some restrictions in place regarding the exact services offered or the number of clients that can be served at one time.

Optometrists should avoid increasing service fees during this time, other than a slight increase to cover the cost of cleaning supplies. While slight increases may not run afoul of price-gouging laws, price increases may not be covered by some insurers. Additionally, price increases can be a deterrent for clients who are impacted by recent economic events.

Telehealth Visits

Depending on the billing code, telehealth visits can be charged by staff for time spent with the patient. Time-based telehealth is generally charged in 15-minute increments unless otherwise governed by state law or insurance rules. Some billing codes may be service-based, even when administered via telehealth. Either way, billing should be done without facility fees or most supply fees.

Keep in mind that many clients’ insurance may not cover telehealth, especially for vision care. Billing staff should double-check clients’ vision insurance before appointments and inform clients if there are any out-of-pocket charges. Optometrists may need to offer alternate payment methods or plans for some patients to proceed with their visit.

Medicare and Medicaid

Since many optometry services are ineligible for Medicare, the applicability of federal rules varies. Currently, federal rules are waiving some telehealth requirements, but the rules pertaining to optometry eligibility are still the same.

As a state-federal partnership, Medicaid rules vary from state to state. Many states are waiving billing rules pertaining to telehealth, including those dictating that telehealth visits are only for rural patients. A few are even allowing coverage for audio-only telephone calls.

The Centers for Medicare and Medicaid Services (CMS) have released a list of telehealth billing codes that physicians can charge during COVID-19. The situation remains dynamic as the pandemic progresses, so optometrists need to stay in touch with their appropriate state agencies and check for other COVID-19 updates regularly.

Other Considerations

In order to maintain patient confidence during this challenging time, optometrists should consider waiving or reducing appointment change fees. Patients are facing unique challenges of their own, especially since schools and childcare facilities are closed.

The technology used in telehealth does not have to be HIPAA-compliant. Since most medical paperwork processing can be done remotely, optometrists should continue allowing staff to work from home and use outsourced bookkeeping where possible. However, practitioners must take due precautions with patient data and use the most secure software and internet connections possible.

Help from a CPA

As optometrists’ business practices grow more complex, one solution is a specialized tax and bookkeeping service. We specialize in optometry services and can assist with a variety of bookkeeping and payroll solutions. Contact us today so we can troubleshoot any problems and help you face the future in these challenging times.