Billing across state lines

[PsychBiller]

New legislation in Georgia effective 1.1.20 now permits a patient to do telehealth from their own home.  As a result of this, one of the doctors that I bill for is planning to close his Georgia practice, and his facility and billing address will now be a Virginia address.

This to me seems to have "claim nightmare" written all over it!  Just because new legislation has come into effect, it will most likely take insurance companies many months to implement these changes, right?

Also, will submitting claims for Georgia patients with a Virginia facility address not just deny automatically as out of state?

I would appreciate any input that anyone can offer.

[Michele]

This is new territory.  I would agree with you, when something is new it's not always implemented right away and usually has many bumps.  I see many areas that can get very sticky.  Billing nightmare might be more accurate.   The place of service is going to show "telehealth" and the patient's address is going to be in box 32 (right?) so the VA facility address isn't too concerning, but there are certainly other things that are.  Each insurance carrier is going to have to adapt to this new legislation and I'm not sure they will all be bound by it.  I'm not a legal expert and I'm hoping Linda will give her opinion on this, but the insurance carriers are nationwide and this is a state legislation.  If the plan doesn't originate in GA is it bound by that law if the patient is in GA?  Lots of concerns.  I wouldn't want to jump so fast on closing the office.  I would want to take a test drive first.
 

[PsychBiller]

You raise a good point Michele about box 32.  I had not thought about having to put the patient's information there, but how else will insurance know that the patient was at home, right? Or will I have to put the POS code as home, and go back to using the GT modifier on the claim line itself to show that it was a telehealth visit?

The insurance companies in GA that I have contacted so far about it have been less than helpful!.....shocker!!

[Michele]

POS should be '02' with the GT or GQ modifier.