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Insurance Stepping Up Telehealth Options

7 minute read

Addiction specialists, insurance companies, and state and federal governments have battled back and forth over how to handle telehealth options. In 2019, 42 states plus the District of Columbia had laws in place regarding commercial insurance and telehealth. It was a step in the right direction though the requirements were widely varied. 

However, the insurance reimbursements rates varied from state to state if they were even reimbursing at all. This made using telehealth options to their fullest potential impossible. Then in 2020, COVID-19 hit the United States, and the country began shutting down. Stay-at-home orders brought to light the need for telehealth insurance coverage. 

Coronavirus Changing Insurance and Telehealth Coverage

March 6, 2020, a Public Health Emergency was declared, allowing addiction specialists and other medical professionals to use telehealth. The order also requires insurance companies to reimburse for all telehealth appointments. 

The following changes to telehealth and insurance are in place for the duration of the public emergency.

Payment for Telehealth Services

Under the emergency orders, physicians can use forms of telehealth to replace in-office and hospital visits. Insurance companies are to treat these services the same as in-office visits and reimburse as such. This order replaces the previous restrictions in place for telehealth. 

Cost-Sharing

Some insurance companies are offering flexible cost-sharing options during COVID-19. Medicare Advantage has waived all out-of-pocket expenses for treatment.

Establishing Patient Relationship Requirements

When the President signed the COVID spending bill, it included language that says a person must have an established relationship with the doctor. Medicare and other insurance companies are allowing these relationships to be established via telehealth. 

Virtual Check-ins

Insurance companies have a fee schedule to provide payment for check-ins. Check-ins are quick communications to decide if an in-office visit is necessary. Some insurances, including Medicare, are allowing check-ins via telephones, audio-video devices, secure text messages, email, and patient portals. Patients that do not feel comfortable with these methods can still choose in-office visits. 

Telehealth Visits

Telehealth visits are the new normal during the pandemic. Virtual visits can replace visits that do not require hands-on medical intervention. The coverage of telehealth visits also include visits for mental health and addiction treatment services. 

HIPAA

HHS also announced they would be using discretion and waiving penalties for HIPAA violations. This only applies if the provider is acting in good faith and only during the pandemic. 

Changing the Future of Tele-Services and Insurance Reimbursement

COVID-19 and shelter-in-place orders have everyone logging on to video services to feel connected to friends and family. These video services are also changing the future of healthcare. With the risk of COVID-19 spreading, the use of telehealth services is exploding. 

Tele-services have been used for many years in healthcare. Insurance reimbursement was always an issue when healthcare professionals billed for the services. Insurance reimbursement issues kept many healthcare professionals from using teleservices. The pandemic is making insurance look harder at the benefits of telehealth, telemedicine, and tele-treatment. 

Telehealth

Telehealth has become increasingly popular due to the rising costs in healthcare and insurance. Life is hectic, and spending hours waiting at the doctor’s office doesn’t fit into daily schedules. Pre-Coronavirus, some healthcare facilities, and insurance companies had some form of telehealth services and coverage. Mainly behavioral and mental health professionals used telehealth. Coronavirus forced everyone to stay home, and telehealth became the new normal for doctor visits. 

With insurance, healthcare professionals, and the government working together, telehealth is our future. Coronavirus has brought to light the time and financial savings that telehealth offers to physicians, patients, and insurance companies. Many large companies are offering telehealth insurance plans that are cost-friendly. These companies are seeing many benefits, such as:

  • Increased access to healthcare
  • A decrease in travel for healthcare
  • Easier to consult with specialists
  • Daily monitoring of chronically ill patients in their home
  • A decline in no-shows for appointments
  • Lower costs
  • Improvement in overall health

Telemedicine

Telemedicine refers to clinical healthcare services offered through telehealth methods. Telemedicine was never used to its fullest benefit, pre-coronavirus. The services being conducted included follow-up visits, treating chronic conditions, specialty consults, and medication management. 

When Coronavirus arrived in America, telemedicine became the only safe way to receive medical care. Doctors and medical professionals quickly increased their telemedicine capabilities despite the assurance of payment from insurance companies. 

Insurance companies with extreme urging from the government have improved their reimbursement policies for telemedicine. With the visible benefits of telemedicine, insurance companies are working closely with medical professionals and software companies to improve telehealth. 

With HIPPA relaxing enforcement during the pandemic, they will eventually go back to enforcing the laws. Building the technology to protect the HIPAA laws while providing excellent telemedicine care is at the forefront of everyone’s minds. 

Telehealth and Online Rehab: The Future of Fighting Addiction

Online Rehab involves getting any help through an internet-enabled device. Addiction treatment centers have increased their telehealth capabilities and expanded their online rehab programs. Stay-at-home orders have caused 12-step programs to move to video-conferenced meetings. There are many options that online rehab offers that in-person rehab does not. 

Privacy is enhanced dramatically by seeking treatment online. Addiction can cause a lot of embarrassment for an individual, and the chance of being exposed prevents some from seeking help. Seeking help through online rehab allows an individual to control who knows about their addiction. Inpatient treatment requires a person to leave their home and job for a period of time. And outpatient treatment exposes a person to be seen entering and exiting treatment centers. Online rehab is not for everyone but has been successful in beating the disease of addiction. 

Flexible scheduling is a great advantage to online rehab. Depending on the program, a person can fit rehab into their busy life instead of fitting their busy life into rehab. Scheduling rehab around available childcare is a massive benefit for a lot of mothers fighting addiction. Travel time to and from treatment and meetings can eat up a big chunk of time, especially high traffic areas. Seeking treatment online from home can save time and money versus in-person treatment. 

Access to treatment is the number one advantage of online rehab. It can be difficult for people in small towns and rural areas to access rehab and addiction services. Many obstacles can get in the way when trying to travel to treatment. This causes some people to give up trying to get sober. With 9 out of 10 Americans having internet service, access to online treatment is highly achievable. 

Safety of Online Rehab

The biggest challenge facing telehealth and online rehab is confidentiality and data security. HIPAA has a set of regulations that protects your health care records. These regulations also apply to the online healthcare system. HIPAA regulations cover your protected health information, how it is stored, and who can access it.

All communications with healthcare workers, including addiction specialists, should be encrypted. Encrypting means to scramble communications into something unreadable. This ensures the highest chance of privacy. 

There are many internet communications, such as email and text messaging, which are not encrypted. It is vital to consult with the treatment center and discuss their policies on protecting your privacy. A treatment center must go through rigorous accreditation and licensure processes to ensure privacy and confidentiality requirements are followed. 

When an individual seeks online treatment through an accredited and licensed center following HIPAA regulations, then YES online rehab is very safe.

Online Rehab Program at Footprints

Thankfully, before Coronavirus, there were many addiction treatment services offered through telehealth. So ramping up the use of telehealth options such as video conferencing and phone calls, for online rehab services was easy. At Footprints, realize the importance of keeping all counseling sessions and medical records completely confidential. It is hard to believe that you can achieve sobriety with online rehab, but you CAN.

Online Intensive Outpatient Programs

An individual in an intensive outpatient program can have great success at beating addiction. And the best part, it is all achieved from the privacy of your own home. In an IOP, you will have scheduled sessions with addiction specialists and counselors. Together you will work on reaching all the goals in your treatment plan. You participate in these sessions through video conferences and other telehealth smartphone apps. 

Telephone-Based Sessions

The telephone-based treatment has been used in addiction after-care for years. And now with the treatment of addiction is being used during early treatment. For those without internet access, phone-based treatment gives them a chance at sobriety from their home. An individual who has a hard time being completely open face-to-face may find it easier to talk over the phone. 

Online Recovery Meetings

All 12-step programs, including Alcoholics Anonymous and Narcotics Anonymous, are being held online. These programs are vital to successful addiction recovery. The connections and support system built during these meetings are a lifeline for many people fighting addiction. Most of these meetings use Zoom and Google Hangouts, so internet access is a must.

Footprints to Recovery is Waiting to Help You

At Footprints, we understand the increasing need for addiction treatment during these times. Our caring staff is waiting to answer all your addiction treatment questions and help you start your online journey to sobriety. What are you waiting for? Click here to talk to one of our addiction specialists.

References:

https://www.aha.org/advisory/2020-03-17-coronavirus-update-cms-broadens-access-telehealth-during-covid-19-public-health

https://www.samhsa.gov/find-help/national-helpline

https://www.asam.org/Quality-Science/covid-19-coronavirus/access-to-telehealth

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