Telemedicine is a technology that allows doctors and patients to connect virtually. A tech that enables providers and other healthcare professionals to diagnose, treat and prescribe medications without meeting the patient in real time. It was precisely due to this that telemedicine had gained unprecedented levels of demand and popularity during the COVID-19 pandemic. It ensured that doctors can work from home and more importantly doctors were able to continue treating their patients without jeopardizing either of their safety.
Physicians and medical practices understanding the benefits and the opportunity for the growth of their business, aggressively began implementing telemedicine. Not to mention, the government and insurance carriers began promoting and supporting telehealth and telemedicine. The biggest show of support in favour of telemedicine and telehealth during the COVID-19 pandemic, was when HIPAA Laws were relaxed by the Office of Civil Rights (OCR) & Department of Health and Human Services (HHS) in order to accommodate telemedicine as much as possible. It was done to ensure that the people could have continuous access to healthcare without compromising on safety. From the private sector, we had commercial carriers actively promoting telemedicine platforms and services and encouraging their networked providers to offer telemedicine services.
Keep in mind that all of these relaxations are temporary and so far only applicable during the coronavirus pandemic. So before you launch a telemedicine practice, here are 13 pointers to ensure that your telemedicine practice is protected and thrives post the pandemic.
Before you start your telehealth & telemedicine practice, please ensure that you are aware of the telemedicine laws of the state that you are located in. Although it is advisable that you go over it with your practices lawyer/law firm, for your personal understanding of the laws you can always have a glance at the document released by the American Telemedicine Association (ATA). The document covers all the specifics regarding telemedicine coverage and it can be filtered state wise. It also explicitly states what is allowed and what is not.
Direct-to-consumer: This method of delivery ensures that your reimbursement for services rendered are covered by the state. In addition it means that the patient can receive their treatment from their place of residence and does not require a medical professional to be present alongside them. Patients are allowed to self report vitals and be instructed by their chosen provider to prescribe treatment. As mentioned earlier, not all states endorse this method of telemedicine delivery. Though there is an advantage that the provider can tailor a protocol of treatment for each patient, it in itself is disadvantageous as well.
Hub-and-spoke: In this method the patient is not allowed to receive treatment from the comforts of their residence. The patient needs to go to a select location that has been predetermined or a location that fits the state guidelines for an originating site (spoke). These sites are usually hselect wings or rooms in a hospital, healthcare center, clinic, doctor’s office or any other similar location. A patient comes over to these locations and connects to the provider located at another site (hub). States that go for the hub-and-spoke method usually proffer up a list of possible sites on request from the provider.
Regardless of your method of delivery, you as an individual provider or provider group must always ensure that your telemedicine delivery model is based on the HIPAA compliant guidelines.
Once you familiarize yourself with the reimbursement laws, you will find out that coverage for telemedicine by Medicare is limited. For the services that are covered by Medicare, they endorse the hub-and-spoke method of telemedicine. This means that the patient cannot receive treatment from their homes. To get any kind of Medicare reimbursement CMS has stated that the location of the hub and the spoke should be one of the CMS designated places. For a list of these places check out the CMS website.
In the majority of the states in America, Medicaid is accepted. A lot of medicaid plans are designed to provide maximum reimbursement to providers for services rendered. So actively support patients with medicaid coverage as reimbursement is guaranteed.
Telemedicine may be widely implemented now, but it is still a fairly new tech when it comes to a patient point of view. Providers need to ensure that their telemedicine services are accessible by patient’s laptops, smart phones, pads and any other PDAs. The telemedicine service should be accessible across all these platforms. As part of the package, the telemedicine should have a help system and a customer support system, to ensure quality and patient satisfaction.
Your telemedicine platform needs to have an IT support on standby. Uninterrupted high-speed internet, a laptop, camera and a microphone are the bare essentials to launch a telemedicine platform. But it does not stop there, to have a fully functioning and reliable telemedicine platform, you need to ensure that your patients can upload data to you securely, you need to ensure that your system can run flawlessly at all times. It would also be better if you have a buffer and transcribing system in place that can automatically add your appointment notes and treatment notes to the medical records.
Do not get caught in the frenzy. You are not implementing a system that can only work during the pandemic. Implement a system that is fully functional at all times and that can adapt to the circumstances. So take your time and decide not just the telemedicine platform, but also the support systems. Like choosing an electronic medical software that can integrate with your telemedicine platform. There are a lot of vendors available, so do your research before you settle on one. Also, while taking your time to choose a telemedicine platform do not put your practice on hold. Use alternatives in the meantime. Going back to the example of integrating with EMRs, you can always record your video chats and have them transcribed later, which is legal, provided the parties involved are aware.
If you are a group practice or a clinic or any health system that has employed additional personnel other than you, then you need to place a telemedicine platform that can be modified easily. You can try to get the input of the personnels involved after doing dry runs before implementing your telemedicine platform. Though it would be best to have a system in place that can easily modify and adapt to the user’s preferences, something that is customizable and that can be easily taught to other users.
Prescription laws are extremely rigid in almost all states. Some states don’t allow any form of prescription of drugs via telemedicine. Some states allow prescription for very specific and precise conditions and the dosage level must also be monitored. So be sure to be informed of the state prescription laws by conferring with your state medical board.
With the rise of telemedicine, geographical constraints are a thing of the past. But in order to be benefitted by this you need to make you get licensed by all the states, only then can you practice medicine. Multiple licenses are crucial for a successful telemedicine practice.
The healthcare industry is a business and telemedicine is an investment. So like any other business, you need to make sure that your practice is providing you the desired return on investment (ROI). Providers generally tend to make the mistake of concentrating on the amount being charged per visit or consultation. This is not enough, you need to make sure you are investing properly on other peripheral factors that can either drain your telemedicine revenue or increase it. You need to concentrate on allotting the right staff or increasing/decreasing your staffing requirements, need to be aware of your network server loads, sometimes a poorly chosen server can drain your data and create a lot of lags in your system that can very well end up being the downfall of your practice.
The best way to keep track of how your business is performing is by choosing a telemedicine platform that can provide you with regular detailed reports on your systems performance. You need a system that employs data analytics and crunch the feedback information, so you can improve your performance and stay on top of your game. Your platform should have the ability to self analyze any unnecessary wastage of resources and should also act as a performance enhancer for your providers. For example, you and your providers should be able to measure how much time and resources are being expended on a daily basis and if the overall performance can be increased with lesser resources.
Medical billing and coding was already complex, vast, stressful and way too time consuming to begin with, and the new coding and reimbursement policies for telemedicine and telehealth related services just compounds it. Make sure you choose the right billing partner, who can handle and can adapt to your AR loads. You need a partner that can provide you with a seamless and scalable RCM solution that works in harmony to resolve both conventional & telemedicine claims.
With these 13 things taken care of, you can be sure to launch a telehealth & telemedicine practice that will be efficient, compliant to all the rules and regulations and most importantly thriving under any circumstances.
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