Telemedicine Workgroup April 3, 2019 1 Our Mission Improving - - PowerPoint PPT Presentation

Telemedicine Workgroup

April 3, 2019

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Our Mission

Improving health care access and

• utcomes for the people we serve

while demonstrating sound stewardship of financial resources

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• Welcome & Introductions
• Telemedicine Overview
• FY2017-2018 Annual Report
• Workgroup Direction & Future

Meetings

• Open Discussion: Questions,

Challenges, Successes

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Agenda

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Telemedicine is a means of providing services through live, interactive audio and video telecommunications equipment. Telehealth is remote monitoring of clinical data through technologic equipment in order to detect minute changes in clinical status.

Health First Colorado Telemedicine vs. Telehealth

Health First Colorado covered services that are:

• Within the scope of a

provider’s practice, and

• Appropriate to be rendered

via telemedicine.

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Covered Services

NOT COVERED:

• Consults via telephone

(interactive audio)

• Fax
• Provider or member

education only

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Confidentiality & Required Disclosures

Required Disclosures

• Member retains option to refuse

services via telemedicine at any time.

• All applicable confidentiality

protections apply.

• 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. Confidentiality

• Same standard of care as in-person

care.

• Record keeping should comply with

Medicaid requirements (10 CCR 2505- 10 8.130.2).

• 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.

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FQHCs + Telemedicine

• The provider where the

member is located is the “originating site” or “originating provider.”

• In most cases, the “distant

provider” is a clinician who acts as a consultant to the member and originating provider.

• Telemedicine in the home

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Originating vs. Distant Providers

Originating Site

• Room + equipment → Q3014
• If provider also provides

clinical services to the member, the provider bills the appropriate procedure code and Q3014.

• May not bill for assisting

distant site provider.

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General Billing Instructions

Distant Provider

• Bill appropriate procedure

code with modifier GT (interactive communication).

• Use Place of Service 02

(telehealth).

Telemedicine: Connecting Member & Provider

FY2017-2018 Annual Report

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Will be sent out to Workgroup once finalized

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

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More Information

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Devin Miller, MPH Clinical Operations Program Manager Devin.Miller@state.co.us Jess Pekala, JD, MS Policy Specialist Jessica.Pekala@state.co.us

Contact Information

Thank You!

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