Telehealth, also known as Telemedicine, is a rapidly growing method of practicing medicine through the use of electronic communication. Telehealth allows providers to reach more patients and grow their businesses by providing health care services, such as primary and specialty care and remote patient monitoring, via video conference rather than requiring patients to travel for an in-person visit to an office or hospital. Through the use of video consultation, providers may be able to retain patients and thereby retain revenue by providing patients with access to specialists through telehealth rather than transferring or referring them elsewhere. However, it is imperative providers engaging in telemedicine maintain compliance with state and federal law, including professional board regulations, which enumerate requirements for the practice of medicine. Additionally, providers must stay abreast of varying reimbursement guidelines for telehealth encounters.
Frier Levitt has developed and reviewed an array of diverse business models that arrange for the provision of telehealth. Each arrangement presents its own challenges and must be structured to ensure compliance with the various laws and regulations including, but not limited to, the False Claims Act, Anti-Kickback Statute, Stark Law, Health Insurance Portability and Accountability Act (HIPAA), Patient Choice laws, state insurance laws, and state professional board regulations.
Opportunities in telehealth exist in many areas of medicine, including:
Improving patients’ access to care can eliminate many unnecessary emergency or urgent care visits, and enhance patients’ interaction and loyalty to a particular physician or practice. By utilizing telemedicine technology, solo practitioners are able to provide a greater continuity of care to their patients, which results in increased patient outcomes and reduced overall cost. Additionally, primary care physicians can more effectively triage their own patients, having full knowledge of the patient’s applicable conditions, in order to recommend appropriate follow up or avoid.
Many patients seek medical care at urgent care centers as an alternative to emergency department visits or for purposes of convenience. Urgent care centers that make telehealth available to patients are able to reduce operating expense and potentially treat a greater number of patients. By implementing telemedicine modalities, these centers can reduce wait times and more efficiently triage patients who may require additional or alternative care. However, like all other providers, physicians practicing in urgent care centers should be aware of the applicable standards of care and thoroughly review their professional liability insurance policies. In the event that a virtual patient visit does not result in a billable encounter, clinicians will remain responsible for the any medical advice provided.
Telemedicine can significantly increase the level and scope of services provided at rural health facilities. Patients seeking care in rural areas can be connected remotely to specialists for convenient and efficient consultations that may otherwise be inaccessible. Pursuant to Medicare reimbursement guidelines, beneficiaries must be located at a “designated originating site,” which includes rural health clinics, in order to qualify for a reimbursable encounter. Rural health facilities can take advantage of this billable service in order to expand specialized services and team based care offered to patients.
Mental Health providers will find significant opportunity by expanding their practices to include telehealth. Telemental health can not only increase the potential to lower a practice’s operating expenses, but clinicians can be more easily accessible to patients in crisis. Care provided by these practitioners often does not require physical presence in order to effectively treat a patient’s condition. Therefore, mental healthcare providers can provide a comprehensive scope of services through virtual encounters while complying with the applicable standard of care. While all providers must review any software and third party platforms to ensure compliance with the requirements of HIPAA, mental health providers should consider the sensitive protected health information in their possession, which may subject them to greater scrutiny.
If your practice is considering the addition of telehealth services, contact Frier Levitt for assistance with the development of a compliant business model.