Telemedicine Workgroup April 3, 2019 1
Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources 2
Welcome & Introductions • Telemedicine Overview • FY2017-2018 Annual Report • Agenda Workgroup Direction & Future • Meetings Open Discussion: Questions, • Challenges, Successes 3
Health First Colorado Telemedicine vs. Telehealth Telemedicine is a means of Telehealth is remote providing services through monitoring of clinical data live, interactive audio and through technologic video telecommunications equipment in order to detect equipment. minute changes in clinical status. 4
Covered Services Health First Colorado covered NOT COVERED : services that are: Consults via telephone • Within the scope of a • (interactive audio) provider’s practice, and Fax • Appropriate to be rendered • Provider or member • via telemedicine. education only 5
Confidentiality & Required Disclosures Confidentiality Required Disclosures Same standard of care as in-person Member retains option to refuse • • care. services via telemedicine at any time. Record keeping should comply with All applicable confidentiality • • Medicaid requirements (10 CCR 2505- protections apply. 10 8.130.2). Members have access to their medical • records. Waiver of Face-to-Face Requirement In-person contact between a health provider and a member is not • required for services delivered through telemedicine. 6
FQHCs + Telemedicine Face-to-Face Requirement • FQHCs can provide services via telemedicine but the visit does not • qualify as a billable encounter. Costs of telemedicine services are included in an FQHCs annual • cost report. 7
• The provider where the member is located is the “originating site” or “originating provider.” Originating • In most cases, the “distant vs. provider” is a clinician who acts as a consultant to the Distant Providers member and originating provider. • Telemedicine in the home 8
General Billing Instructions Originating Site Distant Provider Room + equipment → Q3014 Bill appropriate procedure • • code with modifier GT (interactive communication). If provider also provides • clinical services to the member, the provider bills Use Place of Service 02 • the appropriate procedure (telehealth). code and Q3014. May not bill for assisting • distant site provider. 9
Telemedicine: Connecting Member & Provider FY2017-2018 Annual Report Will be sent out to Workgroup once finalized 10
More Information Telemedicine Billing Manual Under Section “CMS 1500” on Billing Manual Site • Revisions coming soon • Telemedicine Website General Overview • FAQs • Meeting minutes and presentations • Next Meeting: June/July 11
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Contact Information Devin Miller, MPH Clinical Operations Program Manager Devin.Miller@state.co.us Jess Pekala, JD, MS Policy Specialist Jessica.Pekala@state.co.us 13
Thank You! 14
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