Due to COVID-19, many of the hospital clinics shut down and shifted to telehealth services. As we do not know how COVID will impact the rest of the year (or down the road), there is a high likelihood that throughout 2020, clinics will continue to rely on telehealth when able
Telehealth includes: Video Visits AND “Non face to face” (NF2F) aka telephone encounters
We will alert you to any telehealth visits that may be on your schedule, but in general, NF2F will be noted as such on the schedule, or will say telephone call and video visits will be marked as video.
If you are unable to reach a patient for their televisit, please document as an erroneous encounter using the orderset "Erroneous Encounter," and co-sign the visit to a clinic attending as you would if you had conducted the visit.
NF2F:
This is simply a telephone call, but it is acting in lieu of an in-person appointment
Call the patient at the scheduled time and check in to see how they are doing and if they need any refills or adjustments to medications
If adjustments to medications are needed, or any major changes in plan needed, alert a faculty member supervising clinic to approve the changes/plan
The note MUST include a statement that a NF2F encounter was done in lieu of an in-person visit. It must also say the START time and STOP time of the phone call as well as the TOTAL time spent on the call
The rest of the note should appear like a normal note, except no exam will be done
Billing: 99441 for call 5-10 minutes; 99442 for call 11-20 minutes; 99443 for call 21-30 minutes
Video Visits:
Video visits will be done when a follow up patient is able to use the technology, or for any new patients.
To connect with a patient, you must have a smartphone or iPad with Epic Haiku (smarthphone) or Epic Canto (iPad) downloaded. Open up the app and click on the patients encounter, at the bottom right of the toolbar there will be a video icon. Click on that and it will take you to the virtual “clinic room”. Epic can be open on your desktop at the same time in order to document simultaneously
Once connected, you should confirm you are speaking to the patient by asking them to state their name and DOB
Everything you would do in an in-person visit should be done in a video visit. Some exam should be attempted, but it will be limited.
You must include in the note the .telehealth smarthphrase, which brings up a standard statement needed for billing
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Billing:
Can bill similarly to an in-person visit; however, since the exam will be minimal, you could never bill an LOS 5
Can also bill based on time spent in the visit
If you bill based on time, must include the phrase “Greater than 50% of time was spent in counseling and care coordination (total=xx min)
For new patients: LOS 5= 60min; LOS 4= 45min; LOS 3= 30min
For follow up patients: LOS 5= 40min; LOS 4= 25min; LOS 3= 15min