Please read the general guide for incorporating telemedicine in your practice. Online digital E/M is yet another way that you can extend care to patients beyond traditional office visits. As we have always mentioned, ensuring the highest patient access leads to higher patient satisfaction, thereby leading to higher patient reviews and ultimately, contributes to increased patient volumes.
You can deliver online digital E/M synchronously and asynchronously and audio/video phone can be used. Please note that you cannot use a traditional phone. As with the other cases, this has to be patient initiated as well and the patient consent has to be recorded. Patient consent can be verbal and practices do not have to document this consent in any system.
When can you use this?
Consider this vignette – a patient calls in and initiates a virtual check-in. Now, your practice lets the patient know about their options. If the patient then calls back within 7 days, you can take that virtual check-in (lower, G2012) time and add it to the digital E/M code (99421-99423) . Thereafter, you bill ONLY the digital E/M code.
You, of course, cannot use this for communication of test results, scheduling of appointments, or other communication that does not include E/M.
This has to be an established patient, so please keep that in mind. The patient’s problem may be new to the clinician. However, you cannot use this for new patients.
You can use this only once per 7-day period and unfortunately clinical staff time is not included in this.
Documentation and the billing rules are the biggest headaches
As you can see, documenting time and keeping track of all the rules are quite important in most of telehealth situations. While you and your biller can do this manually, it is always recommended to use a telemedicine technology solution that incorporates this rules engine within the software. Otherwise, you end up spending more time and resources in figuring out billing and recording time than the potential profits you could make.
Typically, this is done via a secure patient portal that’s already included in your EMR (whichever EMR you use). However, traditionally, we have seen that adoption of patient portals is low when it is web based and clunky (which most EMR patient portals are). We have seen a much higher adoption and usage of patient mobile apps (like Werq Patients of BHPS member management app) because these apps typically allow you to manage appointments, manage prescriptions, demographics, include provider finders etc.
Our recommendation is to use patient mobile app/portals because patients seem to adopt it more than patient portals.
Once you have your patients on the patient portal / mobile app, your practice should encourage patients to write to your providers. It is a HUGE differentiator from a marketing point of view and is something that should also be put up on the practice/hospital website as well.
You can also advertise this VERY easily by simply sending an SMS to everyone that calls your front desk (e.g. if you leverage a VOIP solution like AWS connect).
Hopefully this gives you enough information to get started with marketing and billing for online digital E/M services. Next, we will look at marketing and managing Inter-professional consultations, how you can bill for them as well.