With the onset of a pandemic, acceleration of telehealth is underway, including new legislation and this is what you need to know about what is telemedicine, how to setup telehealth or telemedicine program, and the major telehealth companies:

· Basic Terminology:

a. Originating Site – the location where the patient is located.

b. Distant Site – the location where the practitioner is located.

c. Telepresenter – The support person at the originating site.

d. Remote Provider – The practitioner who provides the service via telemedicine. 

· Centers for MedicareMedicaid Services (CMS) and most insurances will pay for the following telehealth services provided by:

a. Physicians,

b. Nurse Practitioners (NPs)

c. Physician assistants (PAs)

d. Nurse-midwives

e. Clinical nurse specialists (CNSs)

f. Certified registered nurse anesthetists

g. Clinical psychologists (CPs)

h. Clinical social workers (CSWs)

i. Registered dietitians or nutrition professionals

· Billing can be done from two locations, and there is possibly a bonus:

1. By the professional providing the telehealth service

2. By the originating site facility fee.

3.  BONUS: There is a Medicare Physician Bonus Payment available for certain Health Professional Shortage Areas (HPSA), here is the map for where to find them. https://data.hrsa.gov/tools/medicare/physician-bonus

· The Coronavirus Preparedness and Response Supplemental Appropriations Act of March 6, 2020: Due to the new  legislation CMS has confirmed that telehealth service will be reimbursed as though  the services are provided in person for the duration of the  declared emergency. See https://www.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf

· Elements of Patient-Physician Engagement – To receive reimbursement, all providers must do the following during the telehealth engagement: 

1. Verify the authenticating location and, to the extent possible, the identity of the patient requesting the service;

2. Disclose the provider's identity and applicable credentials;

3. Obtain consent from patient to provide the service after disclosure, use of telemedicine technology, agreement that telemedicine is the appropriate encounter for diagnosis, and any relevant limitations that apply;

4. Patient should be able to seek follow-up care or information from the physician who conducted the encounter;

5. Establish an Emergency Plan for referral of patient to hospital or ER; and

6. The telehealth platform must guarantee a HIPAA required level of privacy.

· *CAUTION* – Prior to providing telehealth services, it is important for the physician or care provider to confirm with  their professional liability insurance that telemedicine is covered by their policy. Telemedicine is a multi-tiered encounter, involving multiple parties and specialized equipment. Possible errors in such encounters can produce uncertainty for all those involved. 

There are many telemedicine companies, but here are the top five according to Investopia: 

1. MyTelemedicine – https://www.mytelemedicine.com/

2. Teledoc – https://www.teladoc.com/

3. Doctor on Demand – https://www.doctorondemand.com/

4. Careclix – https://www.careclix.com/

5. iCliniq – https://www.icliniq.com/en/

If you need help with setting up your telehealth contract, feel free to call or text me.

Ben[KM1] 

[KM1]Hyperlink to your VCF or direct email