Difference between revisions of "DuxWare - Information on Telehealth - Treat your patients and keep the revenue cycle active - 03/19/2020"

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Revision as of 14:11, 24 March 2020

Telehealth Information for DuxWare Providers:

If you are looking for a method to provide telemedicine, and you are not currently using an EHR that has that capability, there are options out there for physicians to still be able to treat their patients and to be reimbursed for their services. RingCentral offers a HIPAA compliant meeting program. You can use any service that works for you. It will not affect the use of DuxWare in anyway. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA): Effective immediately, the HHS Office for Civil Rights (OCR) will exercise enforcement discretion and waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency. For more information: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/index.html Below is the link with information about RingCentral:


CMS Fact Sheet and other telemedicine information:



Medicare – Summary for Telehealth/Telemedicine Services and Guidance

No modifier is required for billing this service for Medicare. Check state requirements for your state and ask your insurer partners for billing specifics they require. Also ensure that you are using Place of Service – 02 (Telehealth).

Medicaid – Summary for Telehealth/TeleMedicine Services and Guidance:

It is important for providers who accept Medicaid Patients to look to their state’s Medicaid sites for guidance in regards to the requirements for Medicaid. For example, Louisiana providers can go to lamedicaid.com and review the latest updates regarding billing requirements for Telehealth encounters at https://www.lamedicaid.com. Louisiana Medicaid has different rules for Modifier appendages, etc.

Excerpt from the LA Medicaid site:

Overall Telemedicine/Telehealth Policy Louisiana Medicaid encourages the use of telemedicine/telehealth with an interactive audio/video telecommunications system, when appropriate, to decrease the potential for patient-to-patient transmission in shared spaces (e.g., waiting rooms) and patient-to-provider transmission. Generally, when an interactive audio/video system is not available, an interactive audio-only system (e.g., telephone), without the requirement of video, may be employed unless service-specific policy indicates that only an audio/video system is permissible. For use of an audio-only system, the same standard of care must be met and the need and rationale for employing an audio-only system must be documented in the clinical record. Telemedicine/telehealth may be used to evaluate patients who report respiratory and systemic symptoms, for example, in a non-emergency situation when a face-to-face visit is not necessary. Further, telemedicine/telehealth may be used to provide routine care for older patients, or those with chronic illnesses, for the purpose of reducing their exposure to healthcare facilities. Louisiana Medicaid, including all Healthy Louisiana MCOs, allows for the telemedicine/telehealth mode of delivery for many common healthcare services. When otherwise covered by Louisiana Medicaid, telemedicine/telehealth is allowed for all CPT codes located in Appendix P of the CPT manual. These codes include, but are not limited to, new and established outpatient office visit codes.

There is currently no formal limitation on the originating site (i.e., where the patient is located) and this can include, but is not limited to, a healthcare facility, school, or the patient’s home. Regardless of the originating site, providers must maintain adequate medical documentation to support reimbursement of the visit. Providers offering services via telemedicine/telehealth must use a secure, HIPAA-compliant platform, if available. If not available, providers may use everyday communications technologies (e.g., audio/video cellular telephones) during the COVID-19 emergency. Providers must adhere to all telemedicine/telehealth-related requirements of their professional licensing board. Several service-specific policies are detailed below in this document.

Billing Instructions (non-FQHC/RHC): Providers must indicate place of service 02 and must append modifier -95. Reimbursement for visits delivered via telemedicine is similar to face-to-face visits, subject to any terms and conditions in provider contracts with Medicaid MCOs. Providers should contact their contracted MCO for information that may affect billing procedures and reimbursement rates. Billing Instructions for FQHCs/RHCs: Providers must indicate place of service 02 and append modifier -95 on the header and on all detailed service lines. Reimbursement for these services in an FQHC/RHC will be at the all-inclusive prospective payment rate on file for the date of service. Telephone-only Evaluation and Management of Symptomatic Patients Effective for dates of service on or after March 13, 2020, Louisiana Medicaid reimburses telephonic evaluation and management services to members who are actively experiencing symptoms consistent with COVID-19. Telephonic evaluation and management services must be rendered by a physician, nurse practitioner, or physician assistant actively enrolled in fee-for-service Medicaid or with one of the Healthy Louisiana MCOs. Services are only to be rendered for the care of established patients or caregiver of an established patient.

Our Louisiana providers can go to the site to get the full document.

Commercial – Summary for Telehealth/TeleMedicine Services and Guidance:

It is important for providers to reach out to their main commercial payers either by phone or web site to get their guidelines conducting Telehealth encounters, and then billing.


Our Team is here to assist you. Please do not hesitate to contact us for assistance. If the information is available to us, we will share it with you. Place of Service “02” for Telehealth is in your system and ready to use.