Telemedicine


TELEHEALTH STARTUP CHECKLIST:

  • Allow an appropriate amount of time for the implementation (6-12 months)
  • Set clear goals that reflect the needs of your patient population
  • Complete an analysis of the projected revenue impact
  • Review the telehealth vendors in your area
  • (See below for considerations on choosing a vendor)
  • Ensure system’s HIPAA compliance via use of secured encrypted transmissions for PHI
  • Complete a data infrastructure analysis and consider a cellular hotspot backup solution
  • Review state rules regarding establishing a patient-physician relationship to ensure this can occur via telehealth
  • Review additional requirements for ICU or hospital telehealth solutions
  • Verify that the patients to be served are eligible for telehealth based on the service area and the insurance they have (Commercial vs. federal)
  • Follow regulations on identifying the patient and performance of an appropriate exam before establishing a diagnosis
  • Verify you are complying with the state laws for your location regarding informed consent (written vs. verbal)
  • Research reimbursement rules for your state, including rules on remote patient monitoring (RPM) billing and any commercial payer requirements for your state, many of which have lifted the CMS-imposed geographic restrictions
  • Compile a CPT code list by payer
  • Verify Medicaid billing/reimbursement rules for your state(s)
  • Verify which payers require a GT modifier
  • Research licensure rules for your state (if there is no reciprocity, providers may require medical licenses in multiple states to offer services outside of your home state)
  • Establish a physician champion to be a resource for all your clinicians
  • Train and educate your staff and providers, including how to maintain eye contact and dress appropriately for a positive virtual patient experience
  • Review malpractice considerations with your malpractice insurance carrier
  • Advertise/market the telehealth services

CONSIDERATIONS WHEN CHOOSING A TELEHEALTH VENDOR:

  • Customer reviews (providers and patients)
  • System compliance with HIPAA and medical boards
  • Type of services provided (e.g., live video visits, mobile friendly, phone, chat, secure messaging)
  • 24/7 service and tech support
  • Integration with current EHR
  • Integration with current practice management system
  • Implementation process
  • Training provided
  • Customizable solutions
  • Marketing support from vendor
  • Provider eligibility requirements (using providers from the practice or using providers from the vendor network)
  • Real-time eligibility
  • Support for insurance claims
  • Integrated telehealth kiosk/carts
  • Cost
 

ADDITIONAL RESOURCES

“Key Changes Proposed in Medicare Physician Fee Schedule Rule” (AAOS NOW)

“Telehealth at a Tipping Point” (AAOS NOW)

“The Future of Orthopaedic Care: Promoting Psychosocial Resiliency in Orthopaedic Surgical Practices” (JB&JS)

“Telehealth Services” (CMS)

 

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