Since the COVID-19 pandemic began, our business environments have changed drastically. With this temporary new normal comes the need to change how we provide services to our patients and generate revenue.
It’s a brave new world for delivering health services using technology for virtual visits and it just got easier with changes to compliance for these patient interactions.
What are the practice benefits to telehealth?
There are many benefits to implementing telehealth within your practice, from improvements to efficiency and overall patient satisfaction and continuum of care, including—equal reimbursement (pays the same as in-person visits), eliminates patient transportation costs, improves patient access to specialists and improves flexibility in scheduling.
Are there any recommended apps for telehealth that are HIPAA compliant?
Due to the fact that there is no one-app-fits-all for practices—an app that works well for one practice may not be secure enough for another—recommendations are at the discretion of the practice owner. That said, the following are established, HIPAA-secure platforms condoned by current legislation:
Are Facebook, Skype, Facetime and Google HIPAA compliant?
These platforms are considered private between the provider and the patient but not HIPAA-compliant. These are approved for temporary use during the COVID-19 pandemic. These are not intended for longer-term use by your practice.
- Google Hangouts
- Facebook Messenger
Zoom: due to significant security issues, the use of Zoom is discouraged at this time.
Facebook Live, Twitch, TikTok, and similar video communication applications are public-facing and should not be used in the provision of telehealth by covered health care providers.
For updated information from the HHS Office for Civil Rights (OCR), please visit their telehealth enforcement page.
FAQ on telehealth and HIPAA during the COVID-19 pandemic from the Office of Civil Rights
For any violations of telehealth, the complaint will be researched and/or enforced by the Office of Civil Rights (OCR). They provided a Notification of Enforcement Discretion related to the suspension of HIPAA rules back in March. There is no deadline on the suspension of federal enforcement, which for now is good news.
The OCR has provided their guidance on telehealth and the suspension of enforcement in this FAQ document. It is important to note that these are federal guidelines. Unless an individual state has waived its privacy laws, then those would still be enforced.
What are the different types of telehealth services?
The three divisions of telehealth are store-and-forward (a.k.a. asynchronous telemedicine) in which health care providers share patient medical information like lab reports, imaging studies, videos, and other records with a provider at another location over a secure platform; remote monitoring, in which health care providers are able to track a patient’s vital signs and activities at a distance; and real-time interactive services, in which patients and providers use video conferencing software to hear and see each other in real-time.
Can I use all three types of telehealth?
Yes, it’s up to the provider in choosing a portion of which telehealth services they wish to implement or a comprehensive array of all divisions. Each division is another way to deliver effective and efficient care and expand access to as many patients as possible.
What telehealth services can bill for Medicaid?
Effective March 6, 2020, and for the duration of COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances, according to the Centers for Medicare & Medicaid Services. In other words, if you could bill for a service before, then you may be able to bill for it now. See the CMS.gov website for more info.
What telehealth service types are most ENT, Audiology, and Allergists offering?
These are real-time voice and video clinic visits for the most acute and complex cases.
These are considered asynchronous visits, where the patient initiates an E/M through a secure web-based application/portal by sending information to the provider who then responds in their own time.
These are considered synchronous visits, via telephone, when a provider conducts a real-time E/M visit with a patient on the phone without the use of video. This is the lowest-tech and fastest telehealth option to market.
How can my medical practice get started with Telehealth?
Here are some steps you should take in order to establish, integrate, and perform telehealth services in your medical clinic. These steps have been provided by the Administrator Support Community for ENT (ASCENT).
- Work with an administrator to identify the goals and needs for implementation.
- Identify the appropriate technologies.
- Check with your malpractice carrier on coverage.
- Determine workflow and how appointments will be made.
- Learn about coding and reimbursement rules.
- Review regulations in your state on telehealth.*
- Set up an area and appropriate technology for televisits.
- Determine which types of patients (new and return) are able to be performed remotely.
- Market the service to current patients.
- Set up templates for proper documentation.
- Set up processes and procedures for patient consent.
- Communicate with all employees.
* During the pandemic, telehealth rules have been relaxed. Please pay attention to information coming out from regulatory agencies as conditions continue to change. When in question, go to your state’s health department for guidance.
Establishing Telehealth Clinical Protocols
It is important that you have a telehealth champion in your office and your staff is well trained on your technology and protocols. Everyone needs to understand why you are implementing the service, the benefits to your practice and your patients and the appointment types you want to prioritize.
Develop Your Protocols
Your specific office protocols will depend on the platform you are using. The following sample is provided by Charleston ENT & Allergy using NextGen.
Tips for Setting Up Great Telehealth Visits
From the lighting in the room to the way you dress, there is an art to creating a good telehealth visit, just as there is for an in-person consult. In the case of a telehealth visit, it is important to understand how your audio and visual technology supports or detracts from the patient experience you are trying to construct. We know patients are embracing this form of communication with their healthcare providers, and we want to help you to make a strong a connection in every type of interaction. To that end, we’ve put together a series of questions and recommendations to help you build your telehealth practice and develop your own unique “webside” manner.
Develop and deliver a Communication Plan
Get the word out that you are open and helping patients. Call, email and send letters to referring physicians and patients as well as promote your services on your website, email and social media platforms.
Links to Useful Information
- HIPAA: US Department of Health and Human Services
- Medicare: Provider Fact Sheet
- General COVID-19 Information: American Speech-Language-Hearing Association
- State Policies: American Speech-Language-Hearing Association
- Commercial Insurance Policies: American Speech-Language-Hearing Association
- CMS Telehealth Codes
- Telehealth Solutions Center: Karen Zupko
- Academy of Doctors of Audiology (ADA) Telehealth Resource Guide