This is a very complex subject and the response is intended only to provide a very broad response.Before you even consider doing telelmedicine, consider: Were you and the patient in the same state where you are licensed or in different states and are you licensed in the state where the patient lives?Are there any limitations based on the interstate compact which preclude you from performing telemedicine?If none of these are problematic, then consider other factors.
The total time you spent on line with the patient is crucial to be documented and can easily be documented by the time the visit was initiated and terminated. These should be accompanied by your signature attestation.
Why you could not see the patient in person and perhaps even more important, is why the patient could not come to your office is secondary but nevertheless should be documented as well as who initiated the virtual visit.
Was the virtual visit audio only or audio and video and what platform software platform was used?
All other E/M components as if you saw the patient in your office are also important.Some components to go a step further, for example would be if the patient’s vitals were to be taken, did the patient have a BP cuff and was it done while you observed? What did you observe about the patients ROM?Did the patient show you snap shot of their blood glucose from the past ten day? In other words how did you come to the understanding of certain findings needs to be documented.Some providers even record the audio/video interaction and download it into the patient’s file.
From the payment status, depending on the carrier, some pay the same for physical and digital encounters others pay less for virutal visits. Some relaxed co payment rules others did not. For certain telemedicine visits specific modifiers are required on the claim form and use the same E/M CPT codes as for physcial encounters.
It is important to understand that many other rules were relaxed during the PHE to allow patients greater access to their doctors. This includes rules regarding HIPAA, locations for both patient and provider and more.
The termination of these relaxation rules may no longer afford you the ability to perform telemedicine using non HIPAA compliant platforms such as facetime, zoom, or other free (or almost free) popular video platforms.And most important, the geographic (urban vs rural) may also revert back topre pandemic status.I would suggest you follow this forum for future updates on Telemedicine as this is a constantly evolving issue.
This is a very complex subject and the response is intended only to provide a very broad response.Before you even consider doing telelmedicine, consider: Were you and the patient in the same state where you are licensed or in different states and are you licensed in the state where the patient lives?Are there any limitations based on the interstate compact which preclude you from performing telemedicine?If none of these are problematic, then consider other factors.
The total time you spent on line with the patient is crucial to be documented and can easily be documented by the time the visit was initiated and terminated. These should be accompanied by your signature attestation.
Why you could not see the patient in person and perhaps even more important, is why the patient could not come to your office is secondary but nevertheless should be documented as well as who initiated the virtual visit.
Was the virtual visit audio only or audio and video and what platform software platform was used?
All other E/M components as if you saw the patient in your office are also important.Some components to go a step further, for example would be if the patient’s vitals were to be taken, did the patient have a BP cuff and was it done while you observed? What did you observe about the patients ROM?Did the patient show you snap shot of their blood glucose from the past ten day? In other words how did you come to the understanding of certain findings needs to be documented.Some providers even record the audio/video interaction and download it into the patient’s file.
From the payment status, depending on the carrier, some pay the same for physical and digital encounters others pay less for virutal visits. Some relaxed co payment rules others did not. For certain telemedicine visits specific modifiers are required on the claim form and use the same E/M CPT codes as for physcial encounters.
It is important to understand that many other rules were relaxed during the PHE to allow patients greater access to their doctors. This includes rules regarding HIPAA, locations for both patient and provider and more.
The termination of these relaxation rules may no longer afford you the ability to perform telemedicine using non HIPAA compliant platforms such as facetime, zoom, or other free (or almost free) popular video platforms.And most important, the geographic (urban vs rural) may also revert back topre pandemic status.I would suggest you follow this forum for future updates on Telemedicine as this is a constantly evolving issue.
I do a great deal of telemedicine in my practice and am currently being audited. What are the most important things to document?