By Dr. Steven Peskin, Executive Medical Director, Population Health Transformation

If telemedicine is an idea you’ve considered but have left to simmer on the back burner these last few years, now is the time to move it to the front burner.

The COVID-19 outbreak is adding new urgency to adopting telemedicine as a vital new care model. In the face of unprecedented challenges to the U.S. health care system, telemedicine offers two critical benefits:

• It’s an effective way to maintain social distancing while still delivering necessary care for patients. In many ways, telemedicine was made for a moment like this – when demand for care exists and delivering that care in a face-to-face visit poses risk to both the patient and office staff.

• It’s at least a partial solution to meeting the surge in demand due to the exponential spread of the virus. Not only does telemedicine offer an opportunity for individual clinicians to operate more efficiently, but it’s also a way to better match supply with demand as cases multiply. Idle capacity in one area can potentially be used to relieve pressure in hot spots, and providers who themselves may be under quarantine but are still healthy can continue to be productive.

In response to the COVID-19 crisis, The Centers for Medicare & Medicaid Services (CMS) has modified its regulations to allow telemedicine services to be delivered to Medicare beneficiaries by phone provided a video capability is available. The Department of Health and Human Services now permits video chats using popular apps, including Apple FaceTime, Facebook Messenger, Google Hangouts and Skype.

Professional organizations have also stepped up and are offering a variety of resources to help providers incorporate telemedicine into their practices. These resources offer useful information on virtually every aspect of telemedicine, including:

• Understanding policy, coding and payment protocols
• Evaluating and selecting a vendor
• Developing new office workflows
• Complying with HIPAA requirements
• Scheduling and documenting patient visits

Here are several resources you might find useful:

• American Medical Association – Quick Guide to Telemedicine in Practice
• American Academy of Family Physicians – Telemedicine and Telehealth Guide
• Centers for Medicare & Medicaid Services – Telemedicine Health Care Provider Factsheet
• American Telemedicine Association – COVID-19 News, Information & Resources
• American College of Physicians –
  • COVID-19 Telehealth Coding and Billing Practice Management Tips
  • COVID-19 Practice Management Resources
  • Practical Guide for Implementing Telehealth into Your Practice
• American Psychiatric Association –
  • Telepsychiatry Toolkit
  • Telepsychiatry and COVID-19 Guide

To encourage telemedicine use here in New Jersey, Horizon Blue Cross Blue Shield

of New Jersey (Horizon BCBSNJ) has announced several relevant policy changes:

• Horizon BCBSNJ has relaxed telemedicine rules to allow our members to receive covered services by telephone. This applies to all covered services delivered by phone or video platforms like Skype and Facetime from in-network and out-of-network providers.

• Horizon BCBSNJ has waived member cost-sharing for covered services provided by in-network providers for a telemedicine visit. This applies to a wide range of in-network providers, although members will still incur out-of-pocket costs for out-of-network providers, according to the specific benefits of their plans.

• Horizon BCBSNJ has ensured that provider reimbursements are consistent with existing policies. For all covered services, providers will be reimbursed at the same rate as if the service was provided in the office. For more information, go to:
  • www.HorizonBlue.com/providernews and
  • https://www.horizonnjhealth.com/providernews.

• Horizon BCBSNJ is also actively expanding tele-visit capacity with New Jersey physicians, Advanced Practice Nurses and Physician Assistants through the Horizon Get Care app.

These, and previously announced modifications to cost-sharing and telemedicine, are in effect through June 30, 2020, although they may be extended depending upon how the pandemic evolves. At this critical time, Horizon wants to make it as easy as possible for our members and for you to take advantage of the telemedicine option.

As recently noted by Kevin Conlin, Chairman, President and CEO of Horizon BCBSNJ, “This modification empowers our members, including our Medicare and Medicaid members, to more easily follow social distancing guidelines while still getting care from the doctors and health professionals they depend on.”