POET LLC

During this time I know there is a lot of information coming from all different directions. We are monitoring several resources to be able to provide you with information.

We know the answers are not always clear. If you have questions or need clarification, please ask.

The question we are working on at this time is about telemedicine and telehealth.

I am on the MGMA community and there are lots of questions and answers regarding the situation at hand. We will do our best to answer your questions by providing documentation.

We do not want to add to the onslaught of reading that needs to be done. This is why we have highlighted some documents provided on here.

My concern is you may need to refer to these documents later to get paid.

We are here to help.

MGMA has released a tool kit for telemedicine and telehealth for COVID-19.

You can find the tool kit under the COVID-19 tag.

Click Here for NEW COVID-19 Care Alert #8

Click Here for COVID-19 Care Alert #6

Power Point provided by the American Academy of Family Physicians (AAFP)

AMA drops CPT Assistant fact sheet on new COVID-19 code

Effective March 13, you can turn to the following code:

• 87635 (Infectious agent detection by nucleic acid [DNA or RNA];severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease (COVID-19)],amplified probe technique)

For the full article

POET will showcase ideas on Telehealth work flow as we find them. Be sure and check the comments for new ideas or add your own ideas!

Resource MGMA community
Does anyone have a tested and working workflow for telemed?   Something like the following?  
1. Review appointment list for appropriate diagnosis and problems to perform telemed
2. Reminder call to patient includes survey to see if they would qualify for telemed visit
3. If video capable, Send patients instructions to install app to phone and request confirmation via email that they have received the invite
4. If not video capable, review if patient is appropriate for televisit only
5. When appointment arrives, staff person pulls up video conf on designated laptop or pc and does initial intake of questions for the physician
6. when completed patient waits for physician to enter the room
7. physician performs video visit and documents in the record.

Another MGMA community resource. From an office manager in Ohio. Zoom (a meetings and workplace app) for example is very easy to use but it is not on the list suggested by CMS  The problem with Skype and Messenger is that they generally require setting up user specific accounts on both ends. My test run with Zoom was simple and we just sent the meeting link to the phone or to the email of the test recipient.  Other opinions would be welcome.  

Texas Medical Board announcement regarding telemedicine http://www.tmb.state.tx.us/page/coronavirus

To view the FAQs

BCBSTX has sent the following message:

” I am hearing from providers that hold times are long right now, so if you hear that from your physicians they are still working on getting everyone access. “

Governor Abbott Waives Certain Regulations For Telemedicine Care In Texas

Governor Greg Abbott today waived certain regulations and directed that the Texas Department of Insurance (TDI) issue an emergency rule, all relating to telemedicine care for patients with state-regulated insurance plans to help doctors across Texas continue to treat their patients while mitigating the spread of COVID-19. The suspensions and emergency rule will work together to allow telemedicine visits for patients with state-regulated plans to be paid the same as in-office visits for insurance purposes. These actions build upon waivers the Governor issued last week of portions in the Occupations Code to expand provider flexibility in providing medical services over the phone.

“As the State of Texas responds to COVID-19, we continue to work to maintain regular health care services and operations throughout the state, and telemedicine is one of the most valuable tools we have to ensure Texans continue to receive the health services they need,” said Governor Abbott. “Expanding telemedicine options will help protect the health of patients and health care professionals, and help Texas mitigate the spread of COVID-19.”

Doctors will be eligible for payment from insurance plans regulated by TDI for medical visits they conduct over the phone instead of in-person at the same rate they would receive for in-person visits. 

Medical providers seeking guidance on the impact of the new rule can expect guidance from the Texas Medical Board to be issued in the coming days, including administrative guidance for billing to ensure that claims are processed smoothly.

Insurers seeking guidance on implementation of the emergency rule should contact TDI or visit their webpage for more information.

This coordinated efforts between the Office of the Governor, the Texas Department of Insurance, the Texas Medical Board, and health insurance plans will increase access to health care for all Texans. Today’s action will expand telemedicine options by giving health care providers greater flexibility to perform audio-only telephone consultations with their patients.

As a reminder, Texans covered by CHIP or Medicaid will not be charged copays for test or telemedicine consults. Individuals covered by Medicare or large employer plans should check with their health plan administrator to determine their specific benefits.