Telemedicine Benefits

1,318 views

Published on

2011 Virginia Telehealth Summit presentation

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,318
On SlideShare
0
From Embeds
0
Number of Embeds
26
Actions
Shares
0
Downloads
30
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Telemedicine Benefits

  1. 1. Telemedicine Benefits Kevin Barger, MBA Virginia Telehealth Summit Tuesday, April 5, 2011
  2. 2. What does telemedicine offer you? <ul><li>Increased Access to Doctors </li></ul><ul><li>Improved Quality of Care </li></ul><ul><li>Improved Continuity of Care </li></ul><ul><li>Reduction of time lost from work </li></ul><ul><li>Reduction of travel costs </li></ul>
  3. 3. Who qualifies to provide these services? <ul><li>Physician office (including NP, PA) </li></ul><ul><li>Rural health clinic </li></ul><ul><li>Federal qualified health center </li></ul><ul><li>Hospital </li></ul><ul><li>Hospital-based or critical access-based renal dialysis center </li></ul><ul><li>Skilled nursing facility </li></ul><ul><li>Community mental health center </li></ul>
  4. 4. Examples of Telemedicine Services <ul><li>Telehealth Consultation </li></ul><ul><ul><li>Inpatient </li></ul></ul><ul><ul><li>Outpatient </li></ul></ul><ul><li>Telehealth Office Visit </li></ul><ul><li>Telehealth Visit </li></ul><ul><ul><li>Inpatient </li></ul></ul><ul><ul><li>Outpatient </li></ul></ul>
  5. 5. What is NOT Telemedicine? <ul><li>Audio-only Telephone </li></ul><ul><li>Home Videoconferencing sessions </li></ul><ul><ul><li>Skype </li></ul></ul><ul><ul><li>Email functionalities </li></ul></ul><ul><ul><li>Fax submissions </li></ul></ul><ul><ul><li>Telephonic monitoring (e.g., pacemakers) </li></ul></ul>
  6. 6. What about referrals or preauthorizations? <ul><li>Under HMO – referrals still required </li></ul><ul><ul><li>Any service requiring a preauthorization continues to do so </li></ul></ul><ul><li>If provider performing the telemedicine service is out of network, an authorization may be required. </li></ul><ul><li>Member cost share does apply if appropriate </li></ul>
  7. 7. How does it get billed? <ul><li>Q3014 </li></ul><ul><ul><li>Billed by the originating site </li></ul></ul><ul><li>Evaluation and Management Codes </li></ul><ul><ul><li>Billed by the provider providing the service or consultation </li></ul></ul><ul><ul><li>Include GT modifier </li></ul></ul>
  8. 8. <ul><li>Anthem Blue Cross and Blue Shield is the trade name of: In Colorado and Nevada: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia (excluding the City of Fairfax, the Town of Vienna and the area east of State Route 123.): Anthem Health Plans of Virginia, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin (&quot;BCBSWi&quot;), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (&quot;Compcare&quot;), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. </li></ul>

×