BRG professionals work with both health insurers and providers of telemedicine services.
As the COVID-19 pandemic has evolved, it has altered the way providers approach the provision of care, and telemedicine has become a critical component of healthcare delivery.
Effective March 6, 2020, and extending through the end of the COVID-19 public health emergency, a telemedicine services expansion waiver for Medicare was issued under the Section 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. The waiver relaxed restrictions for telemedicine services across four broad categories: location, technology, services, and reimbursement. These changes resulted in a dramatic increase in the volume of virtual services, that in turn, bring about both opportunities and risks for providers and payers.
For providers of telemedicine services, BRG professionals offer the following services:
- Professional fee coding, billing, and documentation compliance
- Compliance and risk management
- Compliance program assessments
- Compliance effectiveness assessments
- Enterprise risk assessments
For health insurers, BRG professionals offer the following services specific to telemedicine:
- Evaluate telemedicine reimbursement methodologies; provide recommendations for improvement
- Measure/estimate provider costs for improved accuracy when reimbursing providers
- Benchmark provider reimbursement
- Compliance and risk management:
- Analyze impact of related statutory and regulatory requirements
- Develop and evaluate effectiveness of corporate compliance programs
- Perform fraud and regulatory risk assessment; develop mitigation plans
- Advise on responses to regulatory inquiries and audits; develop corrective action plans
- Operate as an IRO; provide independent monitoring services