Some insurers pay doctors less for virtual visits

Coronavirus

GRAND RAPIDS, Mich. (WOOD) — If you have an appointment with your health care provider soon, it’s likely that visit will be done via computer rather than at the office.

Previously less than 10% of providers’ business, virtual visits have suddenly become nearly all they do. That is especially true for psychological therapists.

“Now it’s 2% in the office, and that’s a couple of children we couldn’t do online, and 98% telehealth in a matter of about two weeks,” said a doctor who runs a local office and did not want to be identified.

He said Priority Health is one of a few insurance companies that are paying offices less for video visits.

“Priority Health is paying us 10% less for telehealth and the insurers are all being admonished to not do that,” the doctor said. “(Insurance providers are) not people I trust. In fact, my fear for my practice is that they might order an audit out of spite and that’s why I want to remain confidential.”

The doctor provided News 8 with receipts that show he gets $96 for an in-office visit from Priority verses $86 for a virtual visit.

Michael Jasperson, a senior vice president at Priority, told News 8 there’s a good reason:

“It’s a much more efficient way for folks involved, so it makes sense that it would cost less for a virtual visit than for an office visit,” Jasperson said. “It has to do with the overhead required for managing a physical office.”

This doctor disagrees.

“It’s actually more because now we have new technology costs,” he said, adding his office has to use HIPAA-compliant systems that are more secure and private. “So it’s actually increased our costs at the same time we’re getting 10% less.”

Priority points to the fact that as COVID-19 cases started to climb, it started allowing across-the-board virtual visits. Previously, only certain areas of medicine were allowed.

“Virtually all payers in the industry, including Medicare, have had these differentials in terms of paying differently for telehealth services versus in-office visits, this is nothing new,” Jasperson said.

The doctor provided paperwork showing that Blue Cross, the state’s largest health insurance provider, actually pays 30% to 40% more for virtual visits over in-office visits. The doctor said this could lead to providers refusing to take Priority because, especially now, the margins for health care providers are low.

“These concerns raised to you are really unfounded, so I was disappointed to hear about it,” Jasperson said.

Priority says when it comes to virtual visits, the pandemic only hastened a change that was coming regardless.

“We think COVID-19 is going to change substantially the industry and the provision of telehealth services,” Jasperson said. “We really think this is the right way to go to transform the way care is delivered. We really do believe it’s going to change things forever.”

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