[NPInfo] Some Private Insurers Mull Reimbursing Virtual Doctor Visits

[Bob Pyke Jr.,RN,CPNP]

Some Private Insurers Mull Reimbursing Virtual Doctor Visits..

Health insurers increasingly are reimbursing physicians for virtual visits, which are seen as a way to cut costs, boost access and provide convenient care, Modern Healthcare reports.

For example, five of the six largest private insurers in Minnesota reimburse physicians $35 for each virtual office visit, and the sixth has recently announced plans to begin reimbursing doctors. 

However, issues such as billing standards and the legal jurisdiction of doctors providing electronic visits while traveling to states where they are not licensed to practice in remain unresolved, Modern Healthcare reports.

Reimbursement Rates

In a study, Paul Tang -- vice president and chief medical information officer for the Palo Alto Medical Foundation in California -- said his organization found that for every $1 employers spent on physician virtual visit programs, they received $4.50 in return. Most of the savings were generated from increasing productivity.

RelayHealth, an e-visit vendor, has developed or is developing reimbursement programs in:


Florida;
Illinois;
Kansas City, Mo.;
Ohio; 
New Jersey; and
The New York City tri-state area.

The RelayHealth program reimburses physicians $30 for reviewing patients' answers to an online interview, which is about 40% of the typical reimbursement for a level three office visit where an established patient presents symptoms at a physician visit, Ken Tarkoff, vice president and general manager of consumer solutions for RelayHealth, said.

WellPoint, the parent company for 11 Anthem Blue Cross and Blue Shield plans and three other companies, has finished a pilot study in Denver and is conducting two pilots in New York and Indiana in which physicians are reimbursed $25 for electronic visits, according to spokesperson Cheryl Leamon.

Medicare Reimbursement?

Despite the increase in private insurers offering reimbursements for virtual physician visits, it is not likely that Medicare will soon reimburse for virtual visits, Modern Healthcare reports. 

CMS Acting Administrator Kerry Weems said that while he is opposed to reimbursements for physician e-mail, he does not oppose paying physicians for electronic care as part of an overall reimbursement package. 

Weems said, "I don't want to reimburse a physician every time he sends an e-mail." He added that doctors might become "very adept" at e-mailing (Robeznieks, Modern Healthcare, 10/17).

Bob,

Co administrator Telehealth List Serve and roving editor at large.
http://www.telehealth.net/interviews/pykebio.html

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