Industries / Telehealth

Telehealth

POS codes, modifiers, and payer policies that change quarterly — virtual care billed right.

Where the revenue leaks.

01

Policy drift by payer

What one payer covers with modifier 95, another denies without POS 10 — and both changed since last quarter.

02

Eligibility for virtual visits

Telehealth benefits differ from in-person benefits on the same plan; assuming parity produces denials.

03

Multi-state complexity

Providers seeing patients across state lines multiply licensure and payer-rule combinations.

How GetMax runs it.

Telehealth rules per payer, current

POS and modifier requirements applied by payer policy as it stands today, not as it stood in 2023.

Virtual-specific eligibility

Telehealth benefits verified specifically — not inferred from in-person coverage.

Clean claims across state lines

Provider, location, and payer combinations validated before submission.

Questions, answered.

Do you keep up with changing telehealth rules?+

Yes — payer telehealth policies are tracked and applied per claim, which matters because they genuinely change quarter to quarter.

Can you verify telehealth-specific benefits?+

Yes — virtual-visit coverage is verified explicitly, since telehealth benefits often differ from in-person benefits on the same plan.