Telehealth For Georgia
If you imagine going to see a doctor, a few experiences might come to mind. For example, you might picture flipping through a magazine in the waiting room before your appointment begins. Further, you might think of your head-to-toe check-up at the beginning of the appointment. Or, you might think about the small talk you have with nurses before the doctor comes. Even though we have several expectations for what happens during a doctor’s appointment, some appointments don’t include any of these things. With the widespread availability of telehealthcare and telemedicine, patients now have more options than ever for staying home and receiving treatment remotely.
What is Telemedicine?
Telemedicine allows physicians to meet with patients remotely. Through online patient portals, video calls, streaming technology, and other forms of telecommunications, doctors can provide care from far away. Through meetings online, physicians can perform the same tasks that they would in an in-person meeting. These tasks include speaking with patients, diagnosing patients, and writing prescriptions for patients. Telemedicine makes it possible to deliver high-quality care from afar.
What is Telehealth?
Telehealth is similar to telemedicine. However, telehealth includes a much broader spectrum of healthcare. For instance, telehealth embodies healthcare education, public health, and health administration, as well as doctor’s appointments. Overall, telehealth encompasses all types of healthcare-related education, meetings, and appointments.
History of Telehealth
Although new technology has made telehealth accessible through video calls, streaming, and other means, remote healthcare started a long time ago.The concept of telehealth really kicked off in the 1950s, when landline phones became accessible to many households. Doctors soon had a new way to conduct meetings with their patients. They could reach patients at home, at a hotel, at their office, or wherever they were. As technology has advanced, telehealth and telemedicine have advanced as well.
Benefits of Telehealth and Telemedicine
Telemedicine offers several benefits as an alternate way to meet with physicians. One benefit is that patients don’t need to spend money on transportation costs or childcare in order to visit the doctor. Also, people can save money by not having to take work off for a doctor’s appointment. Additionally, patients don’t put themselves at risk of contracting new diseases when they opt for telehealth options. Further, they don’t need to spend time in waiting rooms before their appointments.
Patients also have more on-demand health options. They have a better chance of seeing a specialist when they do so through a specialist than they would otherwise. Ultimately, using remote services offer several benefits that make telehealth and telemedicine worth it. If you live in Georgia, we want to help you find the telehealth services that are right for you. Call us today at 912-214-3867 and we will help you find services in your area.
Will Medicare or Medicaid Cover my Telehealth Doctor’s Visits?
If you have insurance through Medicare or Medicaid and you live in Georgia, you might wonder if your insurance covers telehealth and telemedicine. Although it depends on your area, Medicaid and Medicare do provide coverage in most cases. If Medicare and Medicaid deem a service medically necessary, they will cover the service. While this is standard procedure, the COVID-19 has brought an expansion of Georgia’s telehealth and telemedicine services.
Under the title Expansion of Telehealth with 1135 Waiver, this waiver expands Medicare coverage. Through the new waiver, Medicare can pay for the following services: doctor’s office visits, hospital visits, and other services. On March 6, 2020, the Expansion of Telehealth waiver came into effect. Doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers all benefit from this waiver.
Additionally, the waiver reimburses Medicaid services as well, as long as they meet the federal requirements. The three federal requirements are efficiency, economy, and quality of care. Further, the system gives flexibility through federal law to create new payment methods for services. For example, states can reimburse doctors as well as the healthcare facility itself.
Ultimately, Medicare and Medicaid often telemedicine and telehealth, especially now that the Expansion of Telehealth 1135 Waiver has passed. Further, states choose how telehealth is covered, provided, and reimbursed. If payments remain within the Federal Upper Limits, they can choose if and how to reimburse providers.
Telemedicine in Georgia
What we have covered so far explains how Medicare and Medicare cover telehealth services on a national level. However, Georgia has had a functional operating system for several years. Fortunately, Georgia has operated one of the best telemedicine systems in the country for several years. According to Georgia’s Department of Public Health (DPC), the state has a “telemedicine network that is recognized as one of the most robust and comprehensive public health telemedicine networks in the nation and a best-practices model of care to bring specialized care to underserved and rural areas of Georgia.”
Each year, the system operates with an annual budget of $2.4 million. With that funding, the DPH provides more than 50 telemedicine solutions. The telemedicine solutions help people throughout Georgia who need medical help. Also, approximately 500 end points are connected to Georgia’s network. Finally, both ASTHO and the American Telemedicine Association consider Georgia’s program as a best-practice model of care.
In 2003, Georgia’s program began with two pilots in the state. Those researching the pilots studied the efficiency, effectiveness, and utilization of telemedicine. What began with two pilot districts has now expanded to 159 counties in Georgia. Now, the DPH provides telehealth services for dental care, pediatric care, HIV care, genetics, asthma clinics, medical care, and monitoring of high-risk pregnancies. Ultimately, Georgia’s program provides a model for what other telehealth and telemedicine programs can look like.
Will My Insurance Cover Telehealth Treatment?
If you are not covered by Medicaid or Medicare, you might receive your insurance through a private insurance company. If you do, you likely receive coverage through one of the Big Five. The Big Five includes BCBS, Signa, United Healthcare, Aetna, and Humana. Although each of the Big Five have plans that offer telehealth services in some form, many of them only offer them as a policy-dependent medical service. When something is covered as a policy-dependent medical service, only the pricier plans cover the service. For example, gold plans might cover the service. However, a cheaper plan like a bronze plan doesn’t include the service. If you want to find out if your policy covers telehealth and telemedicine, call your insurance provider to ask about your specific policy.
What to Do When You Call Your Insurance Provider
When you call, have several questions ready. Also, have a notebook ready so that you can take notes after your call. The following provides some sample questions that you could ask:
- Will you tell me this call’s reference number?
- My policy number is ___. Does my policy include telehealth services?
- If my policy does include telehealth services, what do telehealth services include?
- Should I use a specific billing code?
- Are there any limitations or restrictions for this service? Is coverage limited to a few times a year?
- To access telehealth services, do I need any special documentation from a doctor?
You need to ask for a reference number so that you will have evidence to prove your case. Further, the representative should be able to answer questions and clarify your issues with coverage.
Does Telehealth Addiction Treatment Work?
Although it feels simple to imagine how doctor’s visits might work in a virtual setting, imagining how something like addiction treatment might work virtually becomes more difficult. If you or a loved one plans to enroll in an addiction treatment program, you likely have certain expectations about what will happen during your treatment. You may imagine walking around the campus of your residential treatment facility, in search of a quiet place to read or write.
Further, you might imagine the strength that comes in group settings for those who suffer from a substance use disorder. You might even imagine the leisurely activities like puzzles, games, walks, or exercise. While addiction can feel isolating, recovery is meant to foster community building. Imagining a telehealth program might feel like the program is missing out on them most important element: shared experience. However, recent studies have found that telehealth addiction programs can provide what someone needs for recovery to be successful.
Telehealth programs allow patients to meet virtually with their clinicians through videoconferencing. They can treat their addiction through medication and therapy though these meetings with their chosen clinician. This method helps people who suffer from substance use disorders. It can also assist those with mental health disorders. A 2011 literature review worked to measure the effectiveness of telehealth rehab centers. Of the 50 studies the researchers reviewed, 76% reported that participants found satisfaction from their care. Clearly, telemedicine works for a large percentage of people who are willing to give it a try.
The authors of the literature review agreed that more researchers should conduct studies in the future. It is important to note that the study also found that sustained participation in telemedicine presented some challenges. However, most studies that the researchers reviewed reported evidence of clinical effectiveness for telemedicine.
The Opioid Crisis and Telehealth
Importantly, some programs offer specific treatments for those who suffer from opioid addictions. Several studies examined psychotherapy treatments and found that telemedicine is effective for treating opioid addiction. Many of these studies found that interventions and treatment via telehealth to be effective through medication treatments as well, just like the study from 2011. One of the studies, published by the American Journal on Addicts, examined the retention of 177 patients who received buprenorphine treatments through telemedicine. The medication buprenorphine helps reverse the effects of opioid addiction.
The study found that after one week of treatment, 98% of the patients had stayed active. After one month, 91% of patients had stayed active. Eventually, they found that 57% of patients had stayed active at three months. Out of the percentage of patients who stayed active during all three months, 86% of them had an opioid-negative urine test. Based on these positive results, researchers determined that buprenorphine treatment via telemedicine can be very successful. If you are struggling with an opioid addiction, telemedicine is an effective choice for recovery.
Especially during a pandemic, finding telehealth options for addiction treatment can help many people. If you live in Georgia and you or a loved one suffers from a substance use disorder, we can help. Please call us today at 912-214-3867.