Your Questions, Answered: How (and When!) to Visit the Doctor's Office Remotely
In this monthly column, VitaLife MD’s Carley Cassity helps us navigate the most exciting research in health and wellness while offering guidance on key holistic health practices to help improve our overall resilience. A Family Nurse Practitioner, Carley Cassity treats her patients by integrating both western and eastern modalities and channels that background into her writing here — backed with evidence and scientific resources.
In the past few months, though it has felt like a lifetime, we have seen the greatest expansion of telehealth since the first telephone was used to perform doctor-to-patient consults in the late 1950s. With a growing number of providers now offering some form of telephone or video consult to meet the needs of the global pandemic, many patients are left with questions surrounding the use, cost and safety of telehealth visits.
1. When should I use telehealth?
Telehealth medicine can be incredibly convenient and time saving when a patient is in need of a referral to a specialist, requires a quick evaluation and medication prescription, or when unsure if they should seek more emergent medical care. Roughly 30% of emergency room visits are non-urgent. However, patients often inappropriately utilize the ER because they require medical attention after hours or because they lack access to specialists or other providers.
With the expanse of nurse help lines and video calls available through many insurance providers, telehealth can serve as the first line of triage and potentially prevent an unnecessary visit to an emergency department or urgent care. The ability to obtain immediate access to a medical provider can aid in proper referral for further evaluation. In some instances, the convenient access to telehealth is the reason that a patient will seek medical help when they otherwise might forgo a visit to the doctor due to cost, time and distance to care. This is alarmingly apparent in rural areas with a 23% higher mortality rate than its urban counterparts and higher rates of preventable ER visits and hospital stays.
Since COVID 19 has forced doctor’s offices to rapidly expand their telehealth capabilities, it is now much easier to perform an initial consult or follow up with a provider if a physical assessment is not necessary.
2. Will my insurance cover a telehealth consult?
If there is one good thing to come from this global pandemic, it is that the laws surrounding telehealth consults have relaxed while reimbursement for telehealth has expanded. Prior to COVID 19, some of the major barriers to telehealth visits were lack of insurance reimbursement to providers and the upfront cost for doctor’s offices to put in place a HIPAA compliant telehealth platform. Telehealth coverage was disparate among insurance providers and laws varied from state to state regarding reimbursement for visits. Now in an effort to broaden patient access to care, many states are mandating that private insurance companies cover and reimburse equally for a telehealth visit as they would for in person visits. In addition, the federal government has loosened restrictions on Medicare programs, allowing seniors better access to telehealth services.
We are continuing to see these laws rapidly changing. For a comprehensive list of coverage and laws by state please click this link.
3. Is my private medical information secure if I utilize an online telehealth platform?
The Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended by the Health Information Technology for Economic and Clinical Health (HITECH) Act served as legal framework for enforcing privacy laws via telehealth to ensure the privacy of patient information. Prior to COVID 19, it was mandatory that telehealth consults were completed via a HIPAA secure platform. Although relaxation of these laws has made it easier for patients to access medical care and for providers to expand their ability to communicate with patients via telehealth, the change in laws may also place some patient information and confidentiality at risk. These laws are regulated enforced by The Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS). Now the OCR and HHS have amended the laws to allow the provider’s discretion in utilizing potentially non-secure platforms to assess patients such as: FaceTime, Facebook Messenger video chat, Skype and others.
The best way for a patient to ensure privacy of their personal data is to inquire about the use of HIPAA compliant platforms prior to their appointment.
I encourage all patients to contact their insurance carriers to inquire about coverage for routine and sick visits. Prior to their virtual or telephone visit, patients should exercise due diligence in contacting the practice to ask if they utilize a HIPAA compliant video platform to protect medical privacy. I believe that we will continue to see a growing number of patients choosing virtual consults with their health care providers due to convenience and the increased access to care that it affords.
As a provider, I am enthusiastic that telehealth will continue to narrow the divide of disparity in our country, broadening access to specialists, cutting down on wait times, and removing several of the barriers to healthcare that have prevented many Americans from receiving adequate and quality health care.
Carley Cassity is a Family Nurse Practitioner with extensive experience in holistic health. Practicing preventive, natural medicine, yoga and meditation in her personal life for many years, she realizes the importance of incorporating alternative and complementary practices into western medicine.
In her current role at VitaLife MD, Carley works alongside a well-established Los Angeles based French physician treating patients throughout the lifespan with an emphasis on preventative care and anti-aging. At VitaLife MD, Carley utilizes herbs supplements, hormone replacement, and peptide therapy to assist patients as they transition through the aging process. She also recognizes the importance of spiritual and emotional health and works in collaboration with acupuncturists, therapists and healers to incorporate meditation, breathwork, psychotherapy into the treatment plan.