pam
New Member
Posts: 1
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Post by pam on Mar 26, 2020 8:35:52 GMT -8
Im a psychiatric APRN. How are you providing daily medication management to ACT patients? At this time clients are not allowed in the office and I'm not visiting thier home. By telephone or a type of telepsych platform? If so, how ate you billing it? Thanks!
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Post by atetrault on Mar 28, 2020 16:42:38 GMT -8
Hi there, I am also a PMHNP, new grad at that and 3 weeks into my position! I am seeing patients via phone while our Telehealth is being set up, but many do not have phones, we have been asked not to do outreach or see in person except on the most necessary appts. I did see a patient this week due for his LAI so I administered the injection and then did a brief med check. I was told to still bill our usual codes,
Ali
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Post by savannatarrant on Mar 30, 2020 7:18:49 GMT -8
Currently for our program, our nurse is prefilling weekly med minders (new ones every time) for our patients. Our staff are dropping them off outside of the homes, calling the patients or caregivers and while staff is in their car, watching them pick up the medications.
our nurse is currently going into patient's home to give injections. in some cases the prescriber has switched to an oral medication.
our prescriber is doing telehealth visits either by phone or video depending on what the patient has available. if the patient does not have a phone our caseworker is going to the home and using their phone.
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Post by sarahs on Mar 31, 2020 13:27:10 GMT -8
Prescriber with savannatarrant above: Also, I am trying to coordinate with our nurse to try and do telehealth visit at the same time she does injection even though we have to move some clients appointments around. My reading of what Medicare is saying right now is that they will pay a regular office visit rate for telehealth visits which Medicare has always resisted before. However, it specifies that this is both an audio and video visit. Its unclear right now (at least to me) how they will reimburse telephone only visits. hip www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet Our agency is using GoToMeeting.com app to do telehealth visits. Some of our clients with smartphones or home computers can do this fairly easily. I am texting them the link to the app then the meeting id number they need to enter. Unfortunately many of our clients don't have internet access or get confused in using the technology. The government is also saying they aren't going to impose penalties for HIPPA violations if the provider is giving a good faith effort "OCR announced on March 17, 2020, it will exercise its enforcement discretion and will not impose penalties for HIPAA violations against health care providers that in good faith provide telehealth using non-public facing audio or video communication products, such as FaceTime or Skype, during the COVID-19" As our nurse is at there at there home anyway to give an injection she will connect me to the client on her iPhone or laptop. When I do my visit the same day, she has less documentation and I get a video visit. For those not on injection, not tech savvy or not tech enabled we're using the phone. Not all of our clients have a phone so for these clients a staff member is going to have to go to their home (unless we can get a family member or group home manager to facilitate) so we can do a visit. I am documenting all my visits with this at the top **Visit today was via telemedicine secondary to COVID-19 Pandemic" substituting phone when necessary. In the beginning we couldn't submit our notes in our EMR because the appropriate coding wasn't there but it is now updated to accommodate telehealth visits. Also, we've been trying to identify if someone in the clients family or home can hold the medication for a month and converting over when we can from weekly to monthly. |
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Post by sarahs on Mar 31, 2020 17:02:42 GMT -8
Addendum: My husband in family practice was also casting around for a telehealth solution and tried Gotomeeting as well as several other platforms. He has a lot of elderly medicare patients (at least compared to his partners) and finally decided Zoom was the easiest for them to navigate.
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Post by chrismccainuw on Apr 1, 2020 11:11:25 GMT -8
In Washington state, providers have been billing for medication-related services (whether med adjustment appointments, med drops, med follow-ups/reminders, teaching about medications/side effects, etc.) using the same codes as previously, but a specifier has been developed to indicate that it was done via telehealth during this pandemic. They include this specifier, along with a location code based on the location of the client (not the provider). I'm not sure if other stats have developed a similar system.
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