What Does My Practice Need to Offer Telemedicine?

May 3rd, 2019 - By Chris Ferguson

TelemedicineTechnology is playing an increasingly important role in the practice of medicine and telemedicine is one such technology. Telemedicine offers practitioners the option of conducting consultations with patients remotely. It may seem complicated but with the right knowledge, and technology, telemedicine can become an integral part of patient care. 


What Kind Of Technology Do Doctors Need To Have?

The technical infrastructure required for a telemedicine visit depends on various factors – the location of the patient and the required type of treatment.  There are different ways of offering this service to patients.

Networked connections – Remote healthcare clinics are connected to larger healthcare facilities via high-speed internet. Part of any telemedicine interaction, therefore, requires the patients to first check in at the site of telemedicine interaction. The medical staff prepares the exam room with diagnostic equipment (in preparation for the communication with the doctor) before the telemedicine interaction begins.

Point to point connections – Linking smaller, remote units with larger, central healthcare systems via high-speed internet. For example – understaffed clinics can outsource care to specialists in bigger clinics within the same healthcare system.

Remote patient monitoring – Providing care from a distance for patients who are looking for immediate and greater access to healthcare for conditions that are non-urgent. This type of encounter utilizes the digital connection between patients home and the healthcare facility.


The payment model for Telemedicine Service

Physicians get reimbursed to deliver telemedicine services through Medicare, Medicaid or through commercial payers.

To get paid through Medicare, the healthcare professional must first be an authorized telemedicine practitioner allowed to provide telehealth consultations to patients. Secondly, the patient receiving the services must be located in an established “telehealth site,” a healthcare facility that is eligible to provide telehealth services. It is also required that the interaction must be in an audio-video setting.

For Medicaid, telemedicine reimbursements largely follow state mandates. They are based on the type of telemedicine service provided, types of healthcare professionals who can apply for reimbursements and patient location during the time of service.

The third way is to get reimbursed through private insurers.  Not all patient insurance covers telemedicine consultations, so providers will need to check on a case-by-case basis.


Types of telemedicine services

There are two types of video telemedicine: direct-to-consumer and hub-and-spoke.

Direct-to-consumer – Doctors furnish telehealth services to a patient in their home. The payer – whether the insurer or the state – has agreed that telemedicine consultation can be carried out without the presence of medical staff.

Hub-and-spoke telemedicine  – Patient must be present at an “originating site”, a healthcare facility where telemedicine is allowed. In this circumstance, a patient must be present at a “spoke” location, with the remote doctor acting as the hub. States that restrict telemedicine keep a record of the sites they permit patients to take telehealth consultations from.


Other Factors Involved In Practicing Telemedicine

For practicing telemedicine across state lines, you’ll need to be licensed to practice medicine in the patient’s location. Providers will not be allowed to treat patients if they do not have a valid license for that area.

To bill insurance for patient treatment, physicians need to quote their physical address. The address is the place where they see the patients in person. Billing for telemedicine is as simple as billing in person. Providers need the same codes for billing in person because insurance companies consider the services rendered via telemedicine to be the same. The only difference is the code that is used for the “place of service.” 

Initially introduced to provide care and treatment to patients in remote areas, telemedicine has now evolved to provide care to patients in convenient settings. Telemedicine creates greater access to treatment anytime, anywhere along with consults with specialists, increased patient engagement and greater quality of care.

PrognoCIS provides the perfect telemedicine platform for your practice.

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