Telemedicine Quick Set up

This was a post from Dr. Fatima Khan in my Physician Telemedicine Group:

Here is a quick way to set up for telemedicine. I know people have asked this in several different threads. 

1. Sign up with doxy.me

2. Use any EHR, practice fusion is cheap 

3. Check with malpractice insurance, most cover telemedicine as added coverage without additional cost/ or check with your employer. 

4. Use the same codes 99213, 99214, 99215 with modifiers. 

5. To document, you can document quite a bit based on visual examination such as alert and oriented, pleasant, no rash, no focal deficits, etc. Under hpi you can documents bp/pulse/Temp if pt gives you that information from home blood pressure machine/thermometer. 

6. Some EHR’s have built in telemedicine platform but they are very pricey. 

I hope this is helpful during this time of crisis. It took me a long time to figure all this out. 

Telemedicine etiquettes: 

Just know with the tele visits have a background that’s professional, wear your coat/stethoscope just professional attire, sit up straight and look right in the camera at the eye level. If you have questions please let know. 

How to bill telemedicine encounters: You can bill just like you would bill any encounter based on the complexity

Your employer may cover you for telemedicine so check with them first, if not then get your own. 

Start with cash and get credentialing in the mean time with insurance companies. I will send some more tips here shortly that I wrote for other people.

It’s best to contact insurance companies and ask them if you are credentialed for telemedicine. Typically you would be. For the starters make sure to tell your credentialing company that you would be doing telemedicine. 

You should document patient’s location. So let’s say they have chest pain during the visit than you can call emergency personnel for them. There is a specific number you have to call for telemedicine emergency kinda like 911. I will have to look that up. Verbal consent for treatment typically is sufficient unless you have way to get written consent. Either way is fine. If you do verbal consent be sure to document. Let’s say if the video encounter fails, disconnects or keeps dropping then your back up would be telephone. During the encounter try to gather as much physical exam findings such as normal speech, alert abs oriented, pleasant, no rash, no focal deficits etc. if they give you information on vital signs take bas home you can document that under as vital signs reported by patient. For assessment and plan it’s just like regular documentation your diagnosis and treatment plan.