There are some major differences between a televisit appointment and an appointment in office. Here are some tips on how to schedule telemedicine appointments and how to collect copays from patients (if any). For understanding the claims part – read this section.
One of the major differences that you will notice – you cannot quite overbook and it’s not that easy to have an overcrowded waiting room.
Another difference is that when your provider sees a patient, a part of the visit time is spent around connectivity (no matter which technology you use). So, what usually takes 10 mins, will end up taking 15 mins. This means that it is hard to pack appointments back to back so your providers can see 30+ patients a day.
You don’t have the grunt work done by a tech in this scenario as opposed to what you do in an office. Typically, in your office, your tech might spent the first 15-20 mins working up the patient and your provider sees the patient for 5 mins. However, the same is not true about a televisit appointment. There’s no tech available to “work up” a patient.
Creating an appointment for an existing patient
Important point to note before creating the appointment.. Ask the patient if they have internet access on their phone. We have encountered some patients that do NOT have internet access on their phones.
If the patient doesn’t have internet access on their phone, ask them whether they have a computer at home AND if it has a webcam (most newer computers have it, but make sure that you confirm this with the patient). If the patient has a webcam enabled desktop, make sure you ask for their email address so that you can email them the confirmation instead of just sending an SMS (they won’t be able to copy the link from SMS to their computer browser).
These minor things end up defining the success of your televisit appointment.
Creating an appointment for a new patient
You might have to create the patient from scratch first – this could be an inbound patient, referred patient, community outreach patient
Important for all new patients – don’t try to gather ALL the required information right on the first call itself. You might be wasting your time. Get the basic information (including insurance coverage) and then get the rest of the patient intake information during your normal patient intake process of appointment reminders etc.
Even more important – make sure that the patient gets their confirmation SMS while you are talking to them on the call.
Patient confirmation SMS
You need patients to confirm their appt using an SMS link because if they can go through that process, you have a confirmation that they are tech savvy enough to click on a link and actually be ready for a televisit.
Sometimes the patients share their children’s cell phone number with the practice AND the child (son/daughter) is also a patient of the practice. ALWAYS let the patient know that you need THEIR cell phone number for a televisit.
After you send the SMS to the patient, call the patient and find out if they could click on the link and everything works well. If this is the case, then will most likely show up for the appointment on time.
The following script would depend on which telemedicine technology you use or whether you use a patient portal or not.
“Hi Deanne, Please click on https://pa.nisoshealth.com to confirm your video call appointment with New York ophthalmology scheduled on 04/22/2020 at 02:45 PM. You can also call us at 1-888-212-3937. For Bengali, reply 1, Hindi, reply 2, Spanish 3.”
ASK THE PATIENT – DID YOU GET MY TEXT?
- If the patient says NO – then confirm the patient mobile number again and try to send the SMS again.
- If the patient says YES – “OK, cool, why don’t I stay on the call while you login to that website. If you have any problems or questions, I am here to help you.”
Confirming televisit appts
It is best if you use televisits in conjunction with a patient app as it makes life much easier. This allows you to have patients confirm their appointments via the patient app itself. Even if you use the patient portal to get the same accomplished, you are good to go.
Calling patients that did not use the patient app
If you have patients that did NOT confirm their televisit appt, call them 1-2 days beforehand and try to get them to confirm their appt on the phone AND to use the patient app to confirm their appt.
Collecting payments for Televisit
First, you need to find out whether your payer is waiving copays during COVID for televisits or not. If they are waiving copays, you CANNOT and should NOT collect copays. If they are not waiving copays for whatever reason, you can collect payments before or after you provide service (it is always preferable to collect payments before providing service).
Decide on a charge for televisits. It is common to charge approximately $45 for self pay patients.
For patients to pay, send them an SMS with a payment link to your patient bill pay portal. Hopefully you are using a bill pay portal – else, running after patients to collect copays ends up being a manual labor intensive and loss-leading process.
“Hi Ronnie, To pay for your video call with New York Ophthalmology please use this link https://billing.nyoph.com and pay $xx” (This $xx could be their copay or if they are a self pay patient, it could be $45).
Make sure that patients get reminders for their televisit appointments. We have noticed that patients tend to forget about televisit appointments quite a bit. Each patient should get an appointment reminder 30 mins before.
It’s a good habit to make sure that the patient gets an appointment reminder 15 mins before as well.
The actual televisit appointment
Be prepared for connectivity issues during televisit appointments. We have noticed that sometimes patients do not a strong enough data signal for the televisit appointment as well. It is best to let the patient know before hand to prepare accordingly. If your provider needs an assistant near the patient (e.g. to assist the patient with a visual acuity test), make sure that you let the patient know that they should have a family member with them during the televisit.
Sometimes it does happen that the patient is running late and doesn’t inform your office that they are running late. To prepare for such cases, ask your provider to wait for a maximum of 5 mins on the call. There’s something you can do in such cases (since you have reserved at least 20 mins for this televisit). Look at your upcoming televisit appointments and send the patient an SMS to enquire whether they would be OK with preponing their appointment to now, We have noticed that in many cases, patients are willing to see the doctor earlier.
You can use this same logic and move patients from appointments in future dates to fill up today’s schedule as well.
Go ahead and do that.
There will be connectivity issues or patients might take a while to get used to televisits, much like providers are getting used to it. At any point in time providers can also send SMS to patients by logging into your telemedicine platform and sending the patient an SMS. So, if the patient is really having trouble connecting, for the time being providers can SMS back/forth with them here.
This is also a billable encounter, hence our advice is not let go of this opportunity just based on connectivity issues.
Hopefully this helps you manage your televisit workflows better. Next let’s look at how to Increase patient access and satisfaction with virtual checkins