by Jennifer Mellick, MD, FAAP
To say that there have been changes in our payments from insurance companies lately is a gross understatement. COVID19 has shook us up and rattled the status quo. In some ways for payment this has been a good thing. Telehealth and even telephone calls are now getting paid. Most I would daresay are even getting paid at parity to in office visits for telehealth provider visits. Payment for telephone advice is a bit more varied in payment, but to see any payment is a vast improvement. I would advise all providers who care for kids to bill for what you do. Right now many of the insurers are paying without cost sharing for the patient.
In addition to paying for telephone visits, it is important that all providers know that CMS changed the RVUs for PHYSICIAN calls to the same as PHYSICIAN in person visits. This is important. If a physician is actually returning a call (or taking an on-call call), document your time and what was discussed and bill appropriately. Then make sure your MCOs know of this change. If we all work together, payment can improve for all of us.
The Pediatric Council has also been working in conjunction with KDHE and the Payor Advocacy Committee to increase Medicaid payment to parity with Medicare payment. This will no doubt be a long arduous task but we will keep at it. Children deserve access to good care and we firmly believe that with improved payments we will see more providers able to accept Medicaid patients. I would like to ask all providers to contact your Kansas legislators to help support Medicaid parity.
We are always happy to hear of any suggestions or problems you are having. Please contact us, we are here for you.