Regulations for telemedicine have relaxed since the stay at home orders were put into place. While telemedicine can seem time consuming and technical for practices, it serves as an innovative tool for rewriting the rules of how to best serve patients. Now is a great time to be creative in redefining patient care.
Below are major points practices should consider regarding telemedicine.
Consent
Conducting patient care remotely involves ensuring the patient is aware of the care they are being given; therefore, a patient record will be created by the caregiver. Practices we've interviewed who have used telemedicine for several years typically prompt the patient at the start of the video visit to state their name, the date, and time, and to mention that they are giving permission to conduct a video visit. Be sure to clearly describe your needs by sending virtual visit instructions to the patient/parent including requirements such as, minimal dress, so the patient can easily be virtually seen.
Billing
All practices are redefining value, billing and counseling patients as it relates to telemedicine.
Here are some useful tips for practices to be aware of:
- Determine whether the patient visit is being conducted using video or over the telephone.
- Document a time component in your notes. For example, “This visit lasted more than 15 minutes of which more than 50% was used for case management and counseling. Remaining time spent in documenting and coordinating patient care.”
- Some practices use the phrase “physical exam deferred due to video visit.” Some practices also document what they can see on the screen. Doctors are also charting video visits needed due to current COVID-19 pandemic shelter in place mandates. As with all patient visits, documents should include all diagnoses and their complexities.
- Practices should be mindful of managing telemedicine billing and how different insurance companies reimburse practices for their time and patient care. Practice billing departments must add a modifier to the visit code which signifies to the insurance company that it is a tele-health visit. Keep up to date on the additional modifiers insurance companies are using.
Here is a link to the, Build a Foundation for Remote Patient Healthcare Services white paper.
The most recent HIPAA-compliant video communication products that you can use for tele-health service includes:
Doxy.me, Google G Suite Meet, Skype for Business, SnapMD, Spruce, Updox, VSee, and Zoom for Healthcare.
Additional support for these technologies:
- A good quality camera
- A strong internet connection
- Lighting
- A microphone
Patients will need:
- A smartphone/tablet or a home computer with a webcam and microphone
Note: You will need to switch your browser to Chrome if using your computer.
- A flashlight
- To make sure your child can interact with the camera if we ask him/her to come close and show us something specific (that may determine whether you use your phone or your computer)
- To have the ability to check your child's temperature and weight
- To be able to share your child's medications and have your pharmacy preference available
Other Useful Resources
- The PMI Forum is a great resource to access up to date information, classes and community. For up to the minute details and resource on Finance, Telemedicine, HR, & General Practice Operations join the PMI Forum. This forum has contributors from the front lines during this crisis. Physicians, Practice Administrators, Lawyers, CPAs, and Vendors, all working together to gather resources, facts, and creative solutions.
- Dr. Una's Telemedicine Masterclass is a great introduction to onboard with tele-health. To enroll, just create an account.
- Dr. Paul Firth and Dr. Una's have a tutorial on how to code Telemedicine visits
- Medicare Telemedicine Healthcare provider fact sheet.
- For Medicare Telemedicine frequently asked questions.
PracticeWell is here to help support and inform our community. We will provide updates to the telemedicine section of our resource library as they become available.
