Reimbursement FAQ

We know navigating the rough-seas of reimbursement can be challenging, but we've put together this FAQ to help ease any troubles!

Where can I find the modifier recommendations?
What does "indeterminable" mean?
Where can I find eligibility determinations?
Why can’t I see Medicare patients through the Chiron platform?
What happens after I click “resolve later”?
How do I bill for telemedicine visits?
Why was my patient charged the self-pay fee?
How do we know what the patient's copay will be before the appointment?
How can we determine eligibility before the appointment is scheduled?
When do we know the amount has been collected?
Where are payments posted/How do we (the practice) post payments?
Can I send my patient a receipt/How do I obtain a receipt?
How can I verify my deposits?
What do I do if my question isn't answered here?

Q: Where can I find the modifier recommendations?
Modifier recommendations can be found in the Billing Details page of the telemedicine platform. See the Modifier Recommendations guide to follow the step-by-step instructions to access the Billing Details page. (top)

Q: What does "indeterminable" mean?
The “indeterminable” eligibility status appears when we are unable to connect with the insurance company. Unfortunately, payer connections can fail. We recommend that you attempt to contact the payer. Otherwise, the appointment defaults to a self-pay rate. (top)

Q: Where can I find eligibility determinations?
The Billing Details page of the telemedicine platform also contains eligibility determinations. See the Eligibility Determinations article for the step-by-step instructions to access the eligibility determinations. (top)

Q: Why can’t I see Medicare patients through the Chiron platform?
CMS has an originating site rule that limits the use of our platform with Medicare patients. The CMS originating site rule restricts the patients' location for telemedicine visits to only CMS approved originating sites. Patients located at an approved originating site are eligible for telemedicine. You can find a list of CMS approved originating sites here: CMS Telehealth Services.

Unfortunately, the telemedicine platform is currently not able to determine the patient's location at the time of the visit. As a result, the platform is not able to accurately determine Medicare eligibility. Medicare patients are always marked ineligible. However, the provider can get an  ABN and offer Medicare patients the service as self-pay. (top)

Q: What happens after I click “resolve later”?
The “resolve later” option allows the provider to skip the charge screen at the end of the appointment. Once the provider skips the charge screen, the billing department can go into the Billing Details page to enter the correct charge amount. View Billing Queue guide for steps on how to enter a charge amount post-appointment. (top)

Q: How do I bill for telemedicine visits?
Telemedicine visits are billed just like in office visits. The Rules Engine offers modifier recommendations, when a modifier is necessary. 

The most commonly used codes are 99212-99214. See the E/M Recommendations article for additional details. (top)

Q: Why was my patient charged the self-pay fee?
All payments collected by Chiron Health require the provider's approval. It is important to review the charge screen at the end of the appointment before clicking the “charge now” button.

We recommend using the “resolve later” feature when the provider is not able to verify the payment amount. Resolve later allows the provider to skip the charge screen. Keep in mind that clicking “resolve later” creates a task in the Billing Queue(top)

Q: How do we know what the patient's copay will be before the appointment?
Unfortunately, this information is currently not available pre-appointment. As an alternative, the practice can directly contact the payer. (top)

Q: How can we determine eligibility before the appointment is scheduled?
Unfortunately, this information is currently not available pre-appointment. As an alternative, the practice can directly contact the payer. (top)

Q: When do we know the amount has been collected?
Payment statuses are available in the Billing Details page. Additionally, you can download a CSV report with detailed payment information. See the Payment Reconciliation Guide for additional information. (top)

Q: Where are payments posted/How do we (the practice) post payments?
Chiron Health does not post payments back into the patient chart (with the exception of Athena, which returns payments as "unapplied payments"). Chiron Health only collects the payment and deposits all payments into the account we have on file for the practice. The practice is responsible for posting the payment back into the patient's chart. (top)

Can I send my patient a receipt/How do I obtain a receipt?
We are working on this request and will notify our clients when the feature is released. (top)

Q: How can I verify my deposits?
You can verify deposits by going to the Billing Details page. In addition, you can download the billing report available for payment reconciliation. See the Payment Reconciliation Guide for additional information. (top)

Q: What do I do if my question isn't answered here?
For questions not covered here, please feel free to contact us at any time! (top)

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