Do You Need Telehealth Insurance Coverage

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Telehealth is essentially the ability to access medical care, doctors, mental health professionals and other counselors without stepping foot in a hospital. Also known as “medical support at home”, telehealth means that some healthcare professionals can now service their patients over FaceTime, a phone call or Skype. In many countries, telehealth is being introduced as a method of receiving medical care at any time during the day, month or year.

There are also methods of telehealth that include real-time home health monitoring devices. These devices store and forward data, images, sound or video from one care site to another for evaluation.

Remote health monitoring might involve recording a patient’s vital signs or different types of health data. The best part about remote monitoring is that it can be done either at home or at another site with trained health care workers.

Whether there is a crisis, a patient is immobile or other reasons that one can’t physically go into a hospital, telehealth services more patients than what would otherwise be possible without it.

Being a telehealth provider is not only wonderful to help different communities, but it is also a smart business decision. It allows you to service more people in a shorter period of time, to stay in business and navigate hard times when the going gets tough. No matter your reason and interest in telehealth, it is always important to have adequate insurance coverage.

Telehealth vs. Telemedicine

Telemedicine is essentially a subset of telehealth. Telehealth can be used broadly to include all health services that use any type of telecommunications technology, but telemedicine usually specifically refers to clinical services.

For example, telehealth can involve general health services such as public health. This might include a public health alert that notifies the public of a disease outbreak or a video-conferencing platform that aids in medical education. Telemedicine, on the other hand, usually involves a clinician providing medical services such as a mobile app that helps physicians treat their patients remotely, or software that lets primary care providers send their patient’s photos off for quick diagnosis or a second opinion.

Who Needs Telehealth Insurance?

There are a variety of reasons why a medical practitioner might want to have Telehealth insurance.

For instance, if you have patients who use medicine regularly, you can use telehealth to fill prescriptions quickly and easily.

Have you ever had a concerned parent sending you a photo of a snake bite or rash? You may already be practicing telehealth and not even know it. If you are speaking with clients outside of the office through a device of some sort, then you should have insurance to cover that.

For those who practice as a psychologist, you might have clients that have trouble making it to your appointments. Psychologist phone counseling through virtual appointments can often help depressed or suicidal persons in getting out of their state of mind. Whether they aren’t feeling their greatest, struggled to get out of bed this morning, or even recently have moved and want to keep you as their counselor, there is an option for online psychological support.

For patients living in a rural area, it might be difficult for them to travel to a hospital or to your office. Sometimes, if clients have questions or concerns, it can be much easier to hop on a video or audio call to ask you these questions instead of coming along in-person. Telehealth could greatly help with these situations. It is also a much more cost-effective alternative to traditional face-to-face consultations or examinations for those who are struggling with their income and finances.

If you happen to work with aging adults, you may already know that for them, getting to a doctor’s office can be a huge challenge. Mobility is often difficult for those who are aging. Telehealth can reduce the costs and the burden of physically going in for a check-up. This is also a similar situation for immune-compromised individuals. Telehealth can help immune-compromised individuals avoid contact with the general public and stay healthy while still receiving care from you.

Do you happen to be serving any of these communities of patients? Perhaps you can see how telehealth could work with your practice. Are you already practicing telehealth? If so, then you need to take precautions in order to protect yourself and your practice by having Telehealth insurance coverage.

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How to Start Practicing Telemedicine

If you are a medical professional and looking to begin providing telehealthcare, there are a few things to think about first:

  1. Contact a local attorney for small businesses. You may need to set up a separate business along with bank accounts and business licenses.

  2. There are two main methods of telemedicine: direct-to-consumer and hub-and-spoke. Direct-to-Consumer: Whoever is paying for the service allows the patient to be at home while receiving these services. There is no need for a medical provider to aid the patient, and the patient can report vitals themselves (when possible). Since not all patients will qualify for this method, another telemedicine method was created. Hub-and-Spoke: This method requires the patient to be in an “originating site.” This means the patient cannot be at home, and must be at one of the allowed facilities by their provider. These facilities are generally specified by the insurance provider or payer and might include healthcare facilities, clinics, a doctor’s office or hospitals.

  3. Make sure to use HIPAA-compliant video methods when practicing telehealth. This is incredibly important as HIPAA has specific regulations that require the video conferencing to be secure.

  4. Telemedicine laws can vary by state. Make sure you are aware if there is a parity law in place in your state and become aware of the coverage available by the American Telemedicine Association.

  5. Although Medicare may pay for limited telemedicine visits, it does not always cover telemedicine completely. Medicare also restricts the patient’s location to specific types of medical facilities, and never allows the patient to be at home. Additionally, the medical establishment that offers assistance must be within a CMS-designated rural area. You will need to confirm if your facility qualifies on the CMS website.

  6. Medicaid is often the best provider with regards to telehealth. Since many patients receiving Medicaid have serious problems, it is a huge supporter of telehealth. This means Medicaid can often also be your best bet as a provider for receiving payment. Just be sure to remember that reimbursement policies need to be reviewed for individual patients as it differentiates situationally.

  7. Prescribing laws vary based on location as well as substance. There are some states that have very strict laws regarding who can prescribe medication through telemedicine and it is important to understand the laws in your state. Some states have completely banned all prescribing through telemedicine, while others allow it for already established patients.

  8. Some doctors choose to practice telemedicine exclusively, but if you are looking to bill insurance, then you will need a physical address to do so. In the case of not having an office to practice in, you will want to set up some form of physical address. This can be a virtual office or executive suite. Even if you work from home, you may want to find an alternative to using your home address as your address will pop up for insurance companies and patients when searching for physicians.

The Risks and Benefits of Providing Telemedicine Services

There are both great benefits as well as a number of risks to consider when providing telemedicine services, which is why you should always have insurance as long as you are practicing telemedicine.

Risks

  • Due to medical license issues, any physician giving care through telehealth services is required to be fully licensed in the state where the patient is located. This means you need to confirm that you are legally able to service your patients or risk losing your medical license.

  • There are Product Liability insurance issues regarding telemedicine. If the technology that you are using to service a patient fails, the care also fails. You will have no way to fix this as you will be working from a remote location.

  • There is the possibility that your internet connection will fail. In certain cases, if the break in communication is sudden, the patient may feel abandoned or unsupported.

  • Remote monitoring is good, but in the event of a sudden emergency, you will need to rely on the staff available. In the case of direct-to-consumer telemedicine, you run the risk of being unable to fully care for your patient or have their needs met.

Benefits

  • With telemedicine, health care and social assistance are more accessible than ever, and you can make a difference without ever leaving your home.

  • As a healthcare provider, you will be able to service more patients than you ever could in normal practice. Telemedicine will allow you to reach those who may not have access to healthcare otherwise.

  • Telemedicine insurance coverage is available to those residing in all 50 states, with the ability to have multiple state coverage on the same policy.

  • Policy premiums are based on your time worked in each state. This means that you may have a lower premium than in standard practice.

  • All specialties have available coverage. Whether you work in dermatology, pathology, internal medicine, radiology, psychology or any other form of medicine, you can get insurance coverage for your specific needs in your industry.

  • For providers who have medical or mobility issues of their own, telehealth is a great opportunity to continue practicing while taking care of oneself.

  • Reduces no-show rates, can help you to manage your time more effectively and waste less time due to late or no-show patients.

What Types of Insurance are Needed to Practice Telemedicine?

Although practicing telemedicine may bring efficiency and cost savings to your practice, there is also an increased liability for the provider offering it. Telehealth insurance coverage for professionals is crucial when providing telemedicine services. There are a few main types of insurance to be aware of.

Professional Liability

This is the general umbrella term that encompasses the many other types of insurance required for operating as a medical professional, as well as telehealth professional.

Professional Liability insurance can also be called professional indemnity insurance or Errors & Omissions (E&O) insurance. _This type of insurance protects you as a healthcare provider from being responsible for the full court costs and lawyer fees stemming from defending yourself against either a negligence claim or another form of a lawsuit. _

Cyber Liability

To increase your privacy exposures from operating on the internet, cyber insurance can be included in whatever other policy you are already practicing with. Cyber Liability will protect you from a data breach of your client’s information, as well as asynchronous failures and device monitoring failures.

Medical Malpractice

Medical Malpractice insurance coverage is essential when practicing telemedicine. Medical Malpractice insurance is a type of Errors and Omissions (E&O) insurance coverage. This type of coverage will protect both physicians and other healthcare professionals from claims made against them by patients or anyone else. These claims might be due to negligent acts, mistakes or anything that causes an injury to a patient.

Although telemedicine has grown significantly in many different healthcare settings, it is still somewhat new. That means there are a few aspects that need to be confirmed when choosing a Medical Malpractice insurance provider as a telehealth professional.

Any and all exchange of healthcare information whether it be before, after or during the consultation needs to be encrypted. You must be sure that the connections you are using for video chatting or calling with patients are done over a private network that satisfies requirements from both HIPAA and HITECH compliance.

How to Make Sure You Have the Right Coverage When Moving to a Telehealth Service

If you have chosen an insurance provider or are continuing with your previous provider, there are a few key things to look out for. You will need to confirm that your current provider will either continue to cover you for telehealth services, or your new provider will supply the necessary components to be a telehealth provider.

First, make sure the state you plan to service is within your coverage and any others that you are legally allowed to service. You need to confirm that your Malpractice Liability extends coverage to multiple states if need be.

Next, clarify if you need to add additional Cyber Liability insurance in addition to Malpractice insurance. Be sure to research HIPAA‐compliant telehealth platforms and finally, simply ask if there are any restrictions or requirements.

Not only is becoming a telehealth professional convenient, but it is also a great way to stay current and competitive in a technological world. As long as you are protected and do your due diligence in terms of telehealth insurance coverage, you should excel in business and improve your practice to stay in business during hard times.

For professional and in-depth service into a custom-tailored insurance package that is right for you, contact CoverWallet today and get started on your path to more comprehensive insurance coverage.

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