Hospitals, doctors and other health care providers seeking an edge in today’s highly competitive healthcare environment would do well to consider a smart telehealth strategy. It’s not an option any more to think telemedicine doesn’t fit into your practices. It is a delivery of medicine that many physicians and providers across the world have bought into.
First, stop thinking in terms of return on investment or revenue created, and instead begin thinking about the value created by your telehealth options for your patients. There are different ways to create value, but you’ll have to decide on the right mix for your patient and practice needs.
This could include options such as self-triage, nurse advice and asynchronous virtual care for common ambulatory conditions (Frequent UTI patient recurrence, “pink eye”, simple injuries and behavioral health issues). For higher-acuity issues it should also include video visits. In-person visits would be reserved for conditions where multiple co-morbidities exist (diabetes and flu, for instance), or when a physical procedure is required (such as cancerous lesion removal).
But the reality is, you still need to find value in this new delivery of medicine. Below are important points to consider as you make a value case for your adventure into the telemedicine world.
Telehealth is an extremely broad category. It encompasses everything from managing complex, high-risk conditions like stroke through remote monitoring and consultation, to providing high-quality, “on demand” convenience care — or virtual care — for a range of acute, episodic and non-emergent conditions in an effective, rapid and cost-effective manner.
It’s estimated that telehealth is an $18 billion industry with significant growth projected. Telemedicine has become an especially established option with specialty consultations for follow-up care, and increasingly for monitoring patients with chronic conditions, in both rural and urban areas. To be safe and effective for patients, telemedicine needs to adhere to a few core principles:
- Licensure: The practice of medicine occurs where the patient is receiving treatment, not where the physician is located.
- Adherence to established standards of care: The standard of care for telemedicine is the same as for in-person care.
- Payment: A medically necessary and covered service should be paid for regardless of how it is provided.
CMS (Medicare) has included in their final physician fee schedule a “Virtual Visit” for 2019. This has been a great addition for established patients that have a quick, but important medical need that can be handled over what is described as “technology-based”.
G2012 brief communication technology-based virtual check-in
Let me start with this. What technology can be used for this technology-based check-in?
Well, it includes the telephone. I’m not kidding you. Here’s a quote from the 2019 Final Rule:
We are persuaded by the comments advising us not to be overly prescriptive about the technology that is used and are finalizing allowing audio-only real-time telephone interactions in addition to synchronous, two-way audio interactions that are enhanced with video or other kinds of data transmission. We note that telephone calls that involve only clinical staff could not be billed using HCPCS code G2012 since the code explicitly describes (and requires) direct interaction between the patient and the billing practitioner.
The service could be performed using more advanced technology, such as a patient portal or a HIPAA compliant video service. But, burying the lead here, they are allowing telephone!
These services are limited to established patients, as defined in the CPT manual: The patient was seen by the treating doctor or NPP or a provider of the same specialty within the last 3 years.
Join us for our important webinar on Telehealth medicine April 16th, 2019
Today the telemedicine field is changing faster than ever before. As technology advances at exponential levels, so does the widespread affordability and accessibility to basic telemedicine tools. For example, not only do we now have the technology for live video telemedicine, but much of the U.S. population has experience using online videochat apps (like Skype or Facetime), and access to a computer or mobile device to use them.
Telemedicine was originally created as a way to treat patients who were located in remote places, far away from local health facilities or in areas of with shortages of medical professionals. While telemedicine is still used today to address these problems, it’s increasingly becoming a tool for convenient medical care. Today’s connected patient wants to waste less time in the waiting room at the doctor and get immediate care for minor but urgent conditions when they need it.
Sign up for this special discussion taking place on on April 16th!
BS, CPC, CCC, CEMC, SCP-CA, ACS-CA, CCS-P, CCS, CMSCS, CMCS, CMC, QMGC, QMCRC
Ms. Terry Fletcher is a healthcare coding and billing consultant based in Southern California. With over 30-years experience, Ms. Fletcher teaches over 100 specialty coding Seminars, Teleconferences and Webinars every year. You can find her CodeCast™ podcast series, focusing on Physician Coding, Billing, Reimbursement, compliance, and Medical industry revenue opportunities, on iTunes, Stitcher, TuneIn, and Google Play.