Telehealth Billing Compliance Review

💲 Price: $2,850 (One-time)
Add-on: Telehealth Policy Toolkit – $250

Overview

Telehealth is here to stay—but billing it correctly remains a moving target. Thrive’s Telehealth Billing Compliance Review ensures your organization aligns with CMS, Medicaid, and commercial payer policies for virtual services. We identify gaps, flag high-risk practices, and help you adapt confidently to evolving regulations.

Ideal for outpatient practices, behavioral health clinics, FQHCs, RHCs, and telehealth-first providers.

What’s Included

• One-on-one review with a certified coding & compliance specialist
• Audit of current workflows, including:
  • Place of service (POS) codes and modifiers (e.g., 95, GT, FQ)
  • Documentation adequacy (synchronous/asynchronous)
  • Telehealth provider credentialing and licensure implications
  • State-by-state parity rule alignment
  • Commercial vs. CMS vs. Medicaid payer nuances
• Sample encounter review (up to 10 claims)
• Recommendations for documentation improvement and claim reprocessing (if needed)
• Optional: Telehealth Policy Toolkit with templated consent language, coding guide, and workflow SOP

Deliverables

• Final Telehealth Billing Compliance Brief (PDF)
• Sample payer grid for top 3 commercial plans
• Modifier/POS usage map by visit type
• Optional add-on toolkit

How It Works

1. After purchase, you complete a brief intake form and securely upload 10 recent telehealth claims.
2. Thrive reviews your documentation, claim setup, and payer mix.
3. A virtual consult is scheduled to walk through findings and recommendations.
4. You receive a Compliance Brief and optional toolkit to support implementation.

ROI & Benefits

• Reduce audit risk related to improper POS/modifiers
• Ensure compliance with state telehealth parity laws
• Improve claim acceptance and reimbursement rates
• Build scalable internal SOPs for hybrid care
• Understand shifting rules across Medicare, Medicaid, and private payers

Timeline & Delivery

• Claims review + consult scheduled within 7–10 business days
• Compliance brief delivered within 5 days of review
• Toolkit available upon request

Compliance Note

All documentation and consults align with CMS, AMA CPT, state parity laws, and HIPAA standards. Thrive signs a BAA with all clients prior to any PHI-related review.