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Healthcare Coverage For Patient Calls

Health Insurance: Should It Cover Phone Calls with Your Patients?   

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Updated on June 14, 2022 by Jordan McGlone

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Telehealth has been on the rise for the past 10 years, and the coronavirus pandemic only accelerated the adoption of telemedicine. People still needed to stay up to date on their medical care, but they did not want to expose themselves to serious infections in the waiting room. As a result, telehealth has become an integral part of the medical system, and it is here to stay. Even though the potential applications of video conferencing with medical professionals are obvious, some people are wondering if this should be expanded to phone calls. Should doctors and healthcare management teams push to get audio-only phone calls covered by health insurance companies? There are several important points to keep in mind. 

The Benefits of Health Insurance Covering Phone Calls 

There are several key reasons why health insurance companies should consider covering phone calls between doctors and patients. They include: 

  • It incentivizes doctors to talk to patients over the phone: First, if doctors know they are being compensated for the time they spend with patients over the phone, they are more likely to return phone calls in a timely manner. They will also be more likely to spend more time with patients on the phone, guiding them in the right direction. This could keep certain patients out of the ER or hospital. 
  • It saves the healthcare system money: When patients are able to solve some of their issues over the phone, they are less likely to go to an in-person doctor’s visit. This reduces the stress placed on other components of the healthcare system, saving the system money. 
  • It decreases abuse of phone calls: When health insurance companies cover the cost of patient phone calls, it reduces the abuse of patient phone calls. Unfortunately, there are some patients who use phone calls as a way to avoid paying for an in-person visit even when one is required. 
  • It reduces barriers to care: Finally, when health insurance companies cover the cost of patient phone calls, they reduce barriers to care. Patients who otherwise would not be able to see a doctor because of transportation issues now have the option to call the office using the phone. 

These are a few of the biggest reasons why health insurance companies should consider covering the cost of patient phone calls and compensating doctors for them. 

The Drawbacks of Health Insurance Companies Paying for Phone Calls 

On the other hand, there are a few drawbacks to a health insurance company covering the cost of patient phone calls. They include: 

  • It adds a co-pay: Even though patients might only have to pay a few dollars, it does add another copay that they need to think about. Patients who are used to calling the doctor for free might hesitate to call the office. 
  • It is not the same as telehealth: An audio-only visit is not the same as a true telehealth visit because the doctor cannot physically see the patient using a traditional phone call. Therefore, some health insurance companies are wondering how to compensate for phone calls when they are not the same as a full visit. 
  • It takes more time: If doctors are being compensated for patient phone calls, they might feel obligated to spend more time over the phone. Even though this might be necessary, it could compromise patient care and other parts of the practice, including in-person visits. 

If health insurance companies are going to cover the cost of patient phone calls, they need to think carefully about how they will do so, what requirements should be put in place, and how patients might feel about this prospect. 

Clearly, there is a lot of information for medical practices to think about. Doctors and hospital management teams need to think carefully about how the prospect of billing health insurance companies for patient phone calls might impact them. Even though there are certain situations where this might be helpful, it can also lead to a paradigm shift in how patients want to address their health concerns. 

Related article: Meeting Patient Demands in the Digital Age. 

Consider Signing up: Answering Services for Medical Offices 

Get the help that your practice needs handling the influx of patient calls. Our dedicated live agents answer their phone calls promptly and treat each patient with care so that your office staff can focus on their job at hand. From medical after hours answering services to daily front desk support, PatientCalls has you covered. 

About The Author

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Jordan McGlone

Jordan has more than seven years of experience working for PatientCalls and a strong background in the healthcare answering service industry. He designs directive plans to fit the unique structure and activities of healthcare organizations, while ensuring that communications are efficient, compliant with HIPAA privacy and security regulations, and support optimal patient care.

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