Sample Page

Frequently Asked Questions

Do I need any special credentials to provide telemedicine?

You must be licensed in the state where the patient is physically located during the telemedicine visit

What equipment do I need? Must you use video capabilities? Do you need a headset?

Every platform has its own capabilities and performs best on certain devices. However, synchronous (live), two-way, audio-visual communication is best practice when using telehealth as a delivery mechanism. Headsets and other audio enhancements are optional, but being able to guarantee optimal sound quality is especially important when using other tools like digital stethoscopes.

The UMTRC cannot recommend specific vendors, but a valuable resource for evaluating your own technology needs can be found here, courtesy of the National Telehealth Technology Assessment and Resource Center. 

Is telemedicine appropriate for all ages and/or specialties?

As a provider, use your best judgment in good faith pursuant to your state medical board's administrative code. 

Can I conduct a telemedicine visit with a new patient, or is it only available for established/returning patients?

During the COVID-19 outbreak, providers can conduct telemedicine visits for both new and returning patients, as long as the consultation is initiated by the patient and properly documented.

Can I order outpatient tests or labs for a patient during a telemedicine visit?

Yes

Can providers prescribe medication during a telemedicine visit?

Yes. However, to prescribe controlled substances, the facility must be a DEA facility and/or the provider must be a DEA provider. More specific information  for your state can be found here.

Pre COVID-19, the patient must have been an established patient who had been seen in-person in order to receive a prescription for a controlled substance during a telemedicine visit.

How do I perform a physical exam? How do I get vitals?

If the patient is in their home, and no one else is present, rely on the patient to give you the best information they have available (height, weight, etc.) and ask them if they have other monitoring equipment like a thermometer, blood pressure cuff, or a fitness device to check their pulse.

What if the patient needs to be seen in-person as a result of the telemedicine consultation?

Follow your practice's/organization's emergency preparedness clinical protocols. If an in-person visit is determined to be necessary, you can still bill the telemedicine visit; reimbursement for this visit is the same as an in-person visit.

How long should a telemedicine visit take?

Schedule the same amount of time as in-person visits and adjust as necessary.

After the COVID-19 outbreak has peaked and subsided, do I lose my ability to provide telemedicine service?

No, especially if you had the ability to see patients via telehealth before the pandemic. Telemedicine encounters will still be billable services. The UMTRC, however, does not know -- at this time -- if federal and state policies will revert to the pre-March telemedicine expansion waiver.

My practice has never offered telemedicine services nor used telehealth as a delivery mechanism, and I am looking to start our own service line and register as a telehealth provider. How do I get started?

We at the UMTRC get this question quite a bit. We are not a telemedicine provider, and registering business within our region is well outside our purview and scope of work as a federally funded technical assistance resource center. While we can definitely answer questions with regards to telehealth adoption, delivery, compliance, and reimbursement, we simply do not have the authority nor capacity to help with business development.

However, we will point you in the direction of these helpful resources that can be the baseline of a step-by-step guide:

Telehealth vs Telemedicine

The terms 'Telehealth' and 'Telemedicine' are often used interchangeably. Each state in the United States has a slightly different definition for these terms, as you can see in the Center for Connected Health Policy's semi-annual State Telehealth Laws and Reimbursement Policies.

In essence, though, 'telehealth' is a broader term that includes not only telemedicine, but is also used for any type of healthcare activity involving technology for preventative, educational, and health-related administrative activities.

According to HealtIT.gov This includes:

  • Live and Interactive (synchronous) Videoconferencing, which includes a 2-way audiovisual connection between a patient and a healthcare provider
  • Store and Forward (asynchronous) Videoconferencing, where a recorded video, image, or data is sent to a remote healthcare provider.  Examples of this could be x-rays, dermatology images like moles or rashes, laboratory data, etc.
  • Remote patient monitoring (RPM), which uses technology to record personal health information like blood pressures, weight, pulse, etc. at a patient's location and sending that data to a healthcare provider in a different location for review.
  • Mobile health (mHealth), which includes both healthcare and other public health information that is provided through mobile devices. 

Telemedicine, on the other hand, refers to the actual clinical encounter for diagnosis and treatment between a patient and a healthcare provider, who are in different locations.

NOTE: It important to realize that telehealth and telemedicine ARE NOT services in and of themselves, but are simply different delivery mechanisms for the same healthcare services that can be delivered in-person.

 

How does telehealth work?

A patient can have a telemedicine consultation at a local healthcare facility that offers telehealth services. There, the patient is connected to a specialist who is in a separate location via HIPAA compliant videoconferencing. 

A nurse or other clinician is often on hand with the patient to conduct physical exam tasks (such as taking vital signs), as requested by the specialist on the other side of the videoconferencing screen. Cameras and other digital monitoring tools allow the specialist to see onscreen exactly what the nurse is seeing in person. 

For example, during a dermatological exam, the specialist is able to zoom in and polarize a view of a skin concern. Aside from the technology, sessions are treated like in-person appointments.

Do healthcare insurance companies reimburse for telehealth and telemedicine services?

In many cases, yes, telehealth and telemedicine services are reimbursed by insurance. However, there are different rules for each healthcare insurance provider. 

Medicare, in general, pays for telemedicine service in rural locations.

All 50 state Medicaid programs and the District of Columbia reimburse for telehealth. But, each state has different nuances that you should become familiar with before starting a telehealth program.

Commercial insurance company reimbursement for telehealth and telemedicine also vary by state.  Some states have what are called 'parity' laws.  A state may have a law for 'parity in coverage' or a law for 'parity in payment' or neither or both. 

'Parity in coverage' means that the commercial insurance company is required by state law to cover healthcare services provided via telehealth and/or telemedicine as if the services were provided in person.    

'Parity in payment' means that the commercial insurance company is required by state law to reimburse healthcare services provided via telehealth and/or telemedicine as if the services were provided in person.

For a comprehensive overview of telehealth reimbursement, check out the state specific reimbursement summaries in the Resources Section of this website, under Reimbursement.

In circumstances where telehealth isn’t covered by insurance, private pay is an option for patients who want to realize the benefits of telehealth, including saving on travel expenses they would normally spend to see a specialist.

How can telehealth benefit our organization?

There are a myriad of telehealth benefits for providers, some of which include increased service offerings within your facilities, increased revenues, enhanced competitive differentiation, and improved patient experience. There are several questions you can ask to help you identify the value telehealth can provide to your organization. If you answer “yes” to one or more of the following questions, telehealth could be a great asset to your organization.

  • Do you have dispersed locations within the same health system?
  • Do you provide outreach services?
  • Do your patients travel to other facilities for services not available at yours?
  • Have you identified health disparities in your community for which you don’t have the services or expertise necessary to provide care?
  • Do your competitors utilize telehealth services and are you losing market share as a result?

To discuss the specific benefits that your organization could realize through telehealth implementation, visit the Contact Us page to connect with an Upper Midwest Telehealth Resource Center staff member.

How do we build a successful telehealth program?

A successful telehealth program requires more than equipment. 

The keys to success include: strategic planning, commitment, C-level support for budget and staffing, a culture that embraces technology as part of the patient-care solution, support of another provider/location to deliver the services you want to tap into via telehealth, and a technology infrastructure that supports the addition of telehealth services. 

For advice on how to get all the necessary components in place for a successful telehealth program, visit the Contact Us page to connect with an Upper Midwest Telehealth Resource Center staff member.

How do we train providers to deliver care via telemedicine?

Many colleges and institutions are incorporating telehealth and telemedicine training into their curriculum. Also, younger generations are so familiar with videoconferencing that speaking with someone via video is normal for them. But, as in all situations, there are some tips and tricks to the trade.  Instead of 'beside manner', the provider must develop their 'webside manner'. 

Training can accomplished in a variety of modalities: in-person workshops, webinars, and/or online modules.  Below are links to several options:

UMTRC Training
Use the Contact Us to get in touch with a UMTRC staff member to discuss customized training options.

National School of Applied Telehealth
https://www.nationalschoolofappliedtelehealth.org/oltpublish/site/cms.do

California Telehealth Resource Center
http://www.caltrc.org/knowledge-center/training/

 

 

Will telehealth someday eliminate the need to visit a doctor's office?

While technology will certainly continue to enhance the delivery of healthcare as we know it, it will likely never eliminate the need for in-person interaction in healthcare. 

Just like email has changed the way businesses communicate, telehealth is changing our definition of the “typical” office visit. 

The results will be improved access to care, lower cost of delivery and, ultimately, improved patient outcomes.

As a patient, how can I access telehealth services?

Access to telehealth and telemedicine services are rapidly increasing across the country. Many commercial insurance companies now offer some type of virtual telemedicine platform. If you’re interested in seeing your provider virtually, call your provider or insurance company and ask whether they offer telemedicine services.

Theoretically, you could use telemedicine for any health concern, because a telemedicine consult is designed to be just like a regular doctor’s appointment.  However, there are still times when it would be more appropriate for a patient to see a healthcare provider in person.  On a broader scale, telehealth and telemedicine can be used for skin cancer screenings, mental health evaluations, orthopedic consults, management of chronic diseases and a wide range of other medical services.

For providers that do not have telehealth capabilities, the UMTRC offers many resources that can help them get started. Have them visit our Resources page to learn more.

Can telehealth programs really improve patient outcomes?  Are there any clinical impact studies for telehealth? 

These days, nearly everyone has a cell phone; sometimes more than one. Children are being introduced to electronic devices like tablets and cell phones at a young age.  As a society, we live our lives connected by social media and cloud-bases apps and verbal response devices.  Is it any wonder that telehealth is becoming more and mainstream?  The world of scholarly telehealth studies is no different.  There are an every-increasing number of studies that demonstrate the effectiveness of telehealth. 

Some evaluate the impact of telehealth on lowering healthcare costs while others look at the business case for telehealth. In terms of the clinical impact of telehealth, there are many reports that highlight the clinical benefits of increased access to care, which telehealth can provide.

The National Consortium of Telehealth Resource Centers have compiled several research catalogues reflecting the efficacy of telehealth.

READ MORE HERE