Telemedicine and how to get paid using it - Dr. Goetter
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Telemedicine and how to get paid using it - Dr. Goetter

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 Telemedicine and how to get paid using it - Dr. Goetter Telemedicine and how to get paid using it - Dr. Goetter Presentation Transcript

  • 2013 Telehealth Alabama W.E. Goetter, MD, FACP, FCCP
  • DISCLOSURES: NONE
  • TELEMEDICINE TELEHEALTH IS:
  • ...the remote diagnosis and treatment of patients by means of Telecommunication technology. (WHO 2007)
  • BARRIERS TO TELEHEALTH • • • • LICENSURE REIMBURSEMENTS INFRASTRUCTURE DEVELOPMENT PRIVACY, SECURITY
  • Two Patterns of Telehealth Store and Forward • Teleradiology • Teledermatology • Telepathology Real Time: Face to Face • Montgomery AIDS Outreach • U of A Telepsychiatry
  • FACE TO FACE Distant Site Provider Originating Site 1. Provider Patient with Provider Patient with Patient presenter Patient 2. Provider 3. Provider
  • ISSUES • Authentication • Informed consent with known limitations with telehealth encounter • Technology appropriate for service rendered • HIPAA • Getting paid for services • Rules and regulations
  • 1997 RULES OF THE ALABAMA BOARD OF MEDICAL EXAMINERS CHAPTER 540-x-16 THE PRACTICE OF MEDICINE OR OSTEOPATHY ACROSS STATE LINES 540-X-16-.01 540-X-16-.02 540-X-16-.03 540-X-16-.04 540-X-16-.05 540-X-16-.06 540-X-16-.07 Authority Definitions License Requirement Qualifications For A Certificate of Qualification For A Special Purpose License Issuance of Certificate of Qualification, Transmittal To Medical Licensure Commission Appeal From Denial of Application For Certificate Of Qualification For Special Purpose License Effect Of Special Purpose License
  • 2009 Connecting Alabama: Broadband & Telehealth Summit
  • 2011
  • 2012
  • 2013 Alabama Board of Medical Examiners Rule Set on Telehealth
  • Alabama Board of Medical Examiners Telehealth Rule Set is ―Totally Reasonable‖
  • HIPAA and TELEHEALTH • Telemed clinic has same duty to safeguard, store and maintain privacy of records. • All transmitted data has to be via ―secure‖ means –this excludes Face Time and Skype applications as commonly used today.
  • The multi-specialty camera with built-in freeze-frame & polarization
  • ENT Scope Dermascope Model 3200 Stethoscope The electronic stethoscope with Bluetooth™ technology lets you hear, visualize, transmit and record body sounds.
  • GE Healthcare Vscan Pocket Ultrasound Pocket-sized ultrasound that may transform the way physicians see their patients.
  • Integrated Telemedicine Cart
  • • Came out of Stanford University PhD Project • Low cost solution to HIPAA-compliant Telehealth
  • MEDICARE TELEHEALTH PAYMENTS • Specific codes with GT modifier • Payments to both distant site provider, and originating site facility • But in Alabama there is no commercial Medigap payment
  • MEDICARE ORIGINATING SITE • Doctor’s Office • Hospital • Rural Health Clinic • Federally-qualified Health Clinic • Hospital-based Dialysis Center • Community Mental Health Clinic
  • TELEHEALTH INSURANCE PAYMENTS STATE MEDICAID COMMERCIAL ALABAMA YES NO GEORGIA YES YES FLORIDA YES NO MISSISSIPPI YES YES LOUISIANA YES YES NATIONAL 42 OF 50 19 OF 50
  • ALABAMA MEDICAID TELEHEALTH PAYMENTS INITIATED: JANUARY 16, 2012 ENROLL: 931, SPECIALITY OF TELEMEDICINE SIGN: TELEMEDICINE SERVICE AGREEMENT BILL BY: SPECIFIC CODES PAYMENT: ABSENT FOR PRESENTING SITE
  • HOME-BASED TELEHEALTH • ZIPNOSIS • TELADOC
  • Sign Up and Start Your Zipnosis
  • Get Started! Start a visit 24/7 — get your Zipnosis 8AM - 8PM, 7 days a week. Prescriptions sent Diagnosis by a Instantly Local Clinician Response back in Online Interview for 1 Hour $25
  • TELADOC • Founded in 2002 • First and largest Telehealth provider with 5 million members • U.S. board certified doctors 24/7/365 • Average doctor call back time: 24 Minutes • 95% member satisfaction
  • TELEDOC 1. 2. 3. 4. Call service Doctor calls back Discuss problem: no time limit Pay for service
  • TELEDOC • • • • • • Cold, flu, bronchitis Allergies, poison Ivy Pink Eye UTI Sinus problem Ear infection
  • TELEDOC DOCS • • • • Board Certified IM, FP, Peds. Active practice with full state license You can apply on their website Docs use phone protocol algorithms
  • UNRESOLVED ISSUE ―The home as an originating site.‖
  • 2nd Annual Alabama Rural Health & TeleHealth Summit 2013 Alabama Partnership for Telehealth is partnering with Alabama Rural Health Association and The Alabama Office of Primary Care and Rural Health for the 2nd Annual Rural Health & TeleHealth Summit 2013 October 16-18 Marriott Legends at Capitol Hill Prattville, AL