Stop Shying Away From Charging for Phone Calls

Society supports payers reimbursing telephone care

If you choose to bill for allergist-made telephone calls, you now have solid backing for your position.

The American Academy of Pediatrics (AAP) recently released a statement advocating physicians charging and payers reimbursing for these services. Surveys show the increasing burden of telephone care. Consider these tips for rethinking your telephone policy.
Tip 1: Consider Charging Acceptable
You may have been reluctant to charge for telephone calls--just like form completion--for fear of alienating parents, causing them to leave your practice. “Yet, anecdotal reports suggest that many of these fees have become commonplace in offices across the country without patient exodus,” the AAP says in its “Policy Statement: Payment for Telephone Care.”

The AAP also argues against two reasons physicians give for not charging for this work:

1. You may have “ethical concerns that billing for telephone care may create a barrier to healthcare access and deter poor families from calling with serious problems,” the AAP says. But this same concern applied to and was unfounded when copayments were first introduced.

In fact, because the U.S. has a market-driven system, justifying giving this service for free is actually harder to support. The AAP instead recommends that citizens and policy-makers debate this issue.

2. Are you worried that charging for telephone calls will place a financial burden on the nation’s healthcare system? Actually, telephone care can avoid higher-costing ED and office visits--reducing, rather than increasing, medical expenses, the AAP says.
Tip 2: Learn Code Categories
Physicians cannot continue to bear the enormous cost of telephone care, says Joel Bradley Jr., MD, with Premier Medical Group in Clarksville, Tenn. “We must learn to recover our costs by using telephone-call codes,” he says.

You may shy away from using telephone-call codes 99371-99373 due to their lack of time allotments. Select the appropriate code based on the level of work, Bradley says. Think of the codes this way:

Tip 3: Document These Phone Details
Thorough notation is key when reporting telephone-call services. “Documentation should fulfill the need for continuity of care, demonstrate the complexity of the call, and meet the requirements of the typical E/M visit,” the AAP states.

Bradley suggests including these documentation items:

• the time spent on the call

• a general note about the encounter’s content including the key elements of history and medical decision-making.
Don’t forget: To demonstrate the expertise required and the complexity of the decision-making process, the AAP suggests that “the physician document the type of telephone encounter.” Keep these examples in mind:

• new problem

• review of chronic problem with change in management

• interpretation of test results

• coordination of care.
Tip 4: Charge for 2 Types of Calls
Not all telephone calls are billable. [...]

- Published on 2007-06-02