Some providers facing issues getting paid for telehealth visits 

With a drop in patient volumes and technical issues arising with telehealth, some healthcare providers are struggling to get paid for virtual visits during the COVID-19 pandemic. 

In Alabama, many rural medical centers lack the infrastructure to support telehealth systems as internet access is "spotty or nonexistent" in certain areas of the state, Christopher Adams, MD, told Dr. Adams, a rheumatologist at Opelika-based East Alabama Medical Center, said about 80 percent to 85 percent of his patients cannot do video appointments. And, for a recent 40-minute phone visit, he said he received $12 from Medicare, the rate for a 10-minute office visit. 

CMS expanded Medicare coverage for telehealth services in March, reimbursing virtual video visits at the same rate as in-person visits, and other big payers followed suit. However, many patients in rural areas still lack broadband internet connection and smartphone devices, preventing them from participating in video visits. 

Due to the pandemic, by mid-March Fultondale, Ala.-based Community Urgent Care's average number patient visits dropped from about 65-70 in-person visits to about 15 telehealth calls per day. The clinic's revenue dropped 80 percent, according to Justin Cooke, MD, a primary care physician and co-owner of the clinic. 

Dr. Cooke and his clinic partners applied for a loan through the small business paycheck protection program to help continue paying the clinic's 20 employees and rent and utilities but learned last week that the program ran out of money. Dr. Cooke told the publication if the funding doesn't come in, the clinic may have to temporarily, or possibly permanently, close. 

“I don’t think there’s any dedicated physician that wants to look at their practice as a business, as a way to make money,” Dr. Cooke said. "But you have to pay staff, pay bills, pay rent. You have to have revenue in order to take care of your patients." 

A small number of physicians that provide virtual care through Teladoc Health's platform also recently experienced payment issues due to the pandemic. The telehealth company said it was delayed in paying some physicians earlier in April due to "growing pains of quickly hiring" to accommodate the COVID-19 surge in user demand, according to The Wall Street Journal

The company has seen its telehealth appointments more than double to 20,000 daily since early March; it hired thousands of new physicians and doubled its number of licensed physicians. 

A Teladoc spokesperson told the publication that more than 98 percent of payments for the period ending March 31 were sent out as scheduled and that the payroll issues have been resolved. 

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