Providing health care services remotely through telehealth has the potential to improve access to care and advance health equity, especially for patients in rural and under-resourced communities. In an effort to understand and ultimately reduce barriers providers face when offering telehealth services, the Office of eHealth Innovation (OeHI) and Prime Health gathered insights into telehealth from Colorado organizations and providers in 2021. Even though Colorado law requires equal payments between in-person and telehealth services for health care, mental health, and dental services, providers reported lower reimbursement rates and denied claims for telehealth as barriers to providing services.
OeHI partnered with Center for Improving Value in Health Care (CIVHC) to study these reported barriers using claims data from the CO APCD and self-reported denied claims from four payers.*
*Methodology: For payment variation, CIVHC analyzed payments for 70 CPT® codes that could have been performed either via telehealth or in-person and calculated median allowed amounts (payer portion + patient portion) using CO APCD data. Denied claims information was requested by Division of Insurance from select payers and provided to CIVHC to analyze telehealth and in-person rates and reasons for denials.
To read the full reports:
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