Success in Telemedicine: The Nitty Gritty on Implementation, Billing, & Patient Engagement — Ranya Habash, MD – Everbridge, Hipaachat

Telemedicine success comes from simple solutions easily adopted by physicians

Telemedicine has been practiced for years where it has been saving taxpayers money such as in the Texas prisons. The problem was that mainstream telemedicine devices were clunky and complicated to use. Physicians then and now were not willing to spend time to learn how to use these devices. However, the demand for telemedicine virtual visits is on the rise and is expected to reach 130M by 2018. What is needed to get physicians on board is simple technology they already know how to use – something as simple as Skype yet with the security standards to meet the federal health privacy regulations.

Best patient use cases for telemedicine

The best patient use cases for telemedicine include consultations, patient follow-ups, patient check-ins, patient transfers and patient monitoring. In these situations, the patients need to travel frequently for repeated sessions when most of the time a face-to-face session is not necessary. Sometimes, it may even be better for doctors to be able to observe and monitor the patients in their home environment.

Telemedicine Reimbursement Issues

One of the biggest concerns of physicians who want to do telemedicine is the issue of reimbursement. Depending on your case, the real situation may not be that bad. If your state has a telemedicine parity law, private payers have to reimburse. The good news is that as of 2017 the majority of states (31) have telemedicine parity laws and seven more have proposed laws. The “Big Five” insurance companies also cover telemedicine: BCBS, Cigna, Aetna, Humana and UHC. CMS

According to CMS (p. 6), “Submit claims for telehealth services using the appropriate CPT or HCPCS code for the professional service along with the telehealth modifier GT, ‘via interactive audio and video telecommunications systems’ (for example, 99201 GT).”

The GT code certifies “that the beneficiary was present at an eligible originating site when you furnished the telehealth service.”

For Medicaid telemedicine reimbursement, “states may select from a variety of HCPCS codes (T1014 and Q3014), CPT codes and modifiers (GT, U1-UD) in order to identify, track and reimburse for telemedicine services.”

Telemedicine lessons from not so successful practices

HealthSpot cobbled together things that weren’t seamless and Doctor on Demand went after the wrong market bypassing the insurance companies. TelaDoc went public and they cannot change things to fulfill the market needs easily now. The biggest problem is insurance doesn’t pay and Medicare rules make no sense as it requires the patients to be in a certain physical location to practice telemedicine. We will see more success if the government changes the rules in the future.

Watch the full video to learn more implementation details of telemedicine systems.


Dr Ranya Habash Telehealth conferenceDr. Habash was named to Castle Connolly’s elite America’s Top Doctors list for 2015, which represents the top 1% of physicians in the nation. She began a successful medical career after the state’s Florida Society of Ophthalmology named her Young Ophthalmologist of the Year “for demonstrating leadership, service, competence, and devotion to the highest ethical and professional standards.” She was then asked to serve as a Board Member and President of the FSO, the governing body for all ophthalmologists in the state of Florida. Dr. Habash was recently appointed to join the faculty of Bascom Palmer Eye Institute, the top eye hospital in the country. As a fun aside, she is the official eye surgeon for the UFC organization, providing surgical and trauma care for the MMA fight champions. Dr. Habash is also Chief Medical Officer of Everbridge and Co-Founder of HipaaChat. She was listed by Becker’s Hospital Review as one of the Top Healthcare Entrepreneurs to Know for 2016.


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