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Email OV and Consults

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  • debbie brosnan
    Does anyone remember reading or seeing information on this subject? Or has anyone attempted to bill for an Email OV? If so how did you do it and did you get
    Message 1 of 8 , Jun 30, 2008
    • 0 Attachment
      Does anyone remember reading or seeing information on this subject? Or has anyone attempted to bill for an Email OV? If so how did you do it and did you get paid?? I am trying to remember where I read about this subject in the recent past.

      Have a great day

      Deb


      [Non-text portions of this message have been removed]
    • Terry Pierce
      Hi Deb, the online evaluation is found on page 432 of the 2008 CPT profesional version, it reads: An on-line electronic medical evaluation is a non face to
      Message 2 of 8 , Jul 1, 2008
      • 0 Attachment
        Hi Deb, the online evaluation is found on page 432 of the 2008 CPT profesional version, it reads:
        "An on-line electronic medical evaluation is a non face to face assessment and management service by a qualified health care professional to a patient using Internet resources in response to a patient's on line inquiry.
        Reportable services involve permanent storage electonic or hard copy of the encounter.  This service is reported only once for the same episode of care during a seven day period, although multiple qualified health care professional could report their exchange with the same patient. 
        If the online medical evaluation refers to an assessment and managment service previously performed an reported by the qualified health care professional within the previous seven days (either qualified health care professional requested or unsolicited patient follow-up) or wihin the postoperative period of the previously completed procedure, then the service are considered covered by the previous assessment and management office service or procedure.  A reportable service encompasses the sum of communciation (e.g. related telehpone calls, prescription provsion, laboratory order) pertaining to the on-line patient encounter.
        For an online medical evaluation provied by a physician use 99444
        98969 On-line assessment and management service provided by a qualified nonphysican health care professional to an established patient, guardian, or health care provider not originatinting from a related assessment and management service provided within the previous 7 days, using the internet or similar electronic communicatiuons network.
        Do not report 98969 when using 99339-993340,99374,99380 for the same comminucations
        Do not report 98969 for anticoagulation management when reporting 99363, 99364
         Terry J. Pierce, CPC



        ----- Original Message ----
        From: debbie brosnan <thebiller_2000@...>
        To: MedicalBillers@yahoogroups.com
        Sent: Monday, June 30, 2008 4:14:20 PM
        Subject: [MedicalBillers] Email OV and Consults


        Does anyone remember reading or seeing information on this subject? Or has anyone attempted to bill for an Email OV? If so how did you do it and did you get paid?? I am trying to remember where I read about this subject in the recent past..

        Have a great day

        Deb

        [Non-text portions of this message have been removed]






        [Non-text portions of this message have been removed]
      • Ms V
        Does this service qualify for payment via telehealth reimbursement? Viola Roberts Mid-Atlantic Healthcare Solutions www.midatlantic-solutions.org The Pieces
        Message 3 of 8 , Jul 1, 2008
        • 0 Attachment
          Does this service qualify for payment via telehealth reimbursement?

          Viola Roberts
          Mid-Atlantic Healthcare Solutions
          www.midatlantic-solutions.org
          The "Pieces of the Puzzle" experts!


          --- On Tue, 7/1/08, Terry Pierce <tpierce301@...> wrote:
          From: Terry Pierce <tpierce301@...>
          Subject: Re: [MedicalBillers] Email OV and Consults
          To: MedicalBillers@yahoogroups.com
          Date: Tuesday, July 1, 2008, 11:09 AM











          Hi Deb, the online evaluation is found on page 432 of the 2008 CPT profesional version, it reads:

          "An on-line electronic medical evaluation is a non face to face assessment and management service by a qualified health care professional to a patient using Internet resources in response to a patient's on line inquiry.

          Reportable services involve permanent storage electonic or hard copy of the encounter. This service is reported only once for the same episode of care during a seven day period, although multiple qualified health care professional could report their exchange with the same patient.

          If the online medical evaluation refers to an assessment and managment service previously performed an reported by the qualified health care professional within the previous seven days (either qualified health care professional requested or unsolicited patient follow-up) or wihin the postoperative period of the previously completed procedure, then the service are considered covered by the previous assessment and management office service or procedure. A reportable service encompasses the sum of communciation (e.g. related telehpone calls, prescription provsion, laboratory order) pertaining to the on-line patient encounter.

          For an online medical evaluation provied by a physician use 99444

          98969 On-line assessment and management service provided by a qualified nonphysican health care professional to an established patient, guardian, or health care provider not originatinting from a related assessment and management service provided within the previous 7 days, using the internet or similar electronic communicatiuons network.

          Do not report 98969 when using 99339-993340, 99374,99380 for the same comminucations

          Do not report 98969 for anticoagulation management when reporting 99363, 99364

          Terry J. Pierce, CPC



          ----- Original Message ----

          From: debbie brosnan <thebiller_2000@ yahoo.com>

          To: MedicalBillers@ yahoogroups. com

          Sent: Monday, June 30, 2008 4:14:20 PM

          Subject: [MedicalBillers] Email OV and Consults



          Does anyone remember reading or seeing information on this subject? Or has anyone attempted to bill for an Email OV? If so how did you do it and did you get paid?? I am trying to remember where I read about this subject in the recent past..



          Have a great day



          Deb



          [Non-text portions of this message have been removed]



          [Non-text portions of this message have been removed]


























          [Non-text portions of this message have been removed]
        • Lin
          Aetna and Cigna are paying but with guidelines. Here is a good overview of the guidelines in an article:
          Message 4 of 8 , Jul 1, 2008
          • 0 Attachment
            Aetna and Cigna are paying but with guidelines. Here is a good overview of
            the guidelines in an article:



            http://www.familydocs.org/news-media/practice-management-news.php


            Practice Management News





            ·News + Media <http://www.familydocs.org/main-sections/news-media>

            GOOD NEWS FOR THE VIRTUAL OFFICE VISIT:
            HEALTH PLANS ARE BEGINNING TO PAY!
            May 2008

            Web-based doctor visits are increasing in popularity, and patients and
            providers alike express appreciation for the convenience of this type of
            encounter. One major challenge, however, has been payment. While CPT had
            developed a code for non-face-to-face visits, many plans would not pay for
            them. Recently, several plans have recognized the value in the service. In
            fact, since the beginning of 2008, Aetna Inc., the country's largest
            insurer, and Cigna, have agreed to pay physicians for online visits. Experts
            expect other large health plans to follow suit.

            Online visits typically cost the same as a regular office visit and are
            aimed primarily at those who already have a doctor (i.e., established
            patient visits). They are best for follow-up consultations and treatment of
            minor ailments such as colds and sore throats.

            Although face-to-face doctor visits will always be needed, the recent moves
            are evidence that long-delayed efforts to bring American medicine into the
            digital age may be gaining momentum, experts say.

            "Paying doctors to do more patient care over the Internet is a small but
            important step in a good direction," said David Cutler, a Harvard University
            health care economist. "It increases patient access and could significantly
            improve their satisfaction."1 Time spent with a physician is a great
            predictor of patient satisfaction.

            Why Offer Online (Virtual) Services?

            Offering your patients access to Web-based services is useful for many
            reasons. While online services may not be face-to-face, they are considered
            direct patient contact and a great value when patients consider time with
            their physician. In addition:

            1. It has been shown that office visits can be reduced by 25 percent by
            using online communication with patients. This allows more time with
            existing appointments, as well as the possibility for a few more open
            appointment slots.

            1. Virtual visits are an opportunity for enhanced payment.

            Guidelines for Non Face-to-Face Services:

            The 2008 edition of CPT established codes for online Evaluation and
            Management (E/M) services provided by both physician and non-physician
            providers. Along with these codes came guidelines for provision of the
            service and use of the code(s):

            · Service provided by a physician or non-physician to the patient at
            the request of the patient or guardian of patient;

            · Patient is required to be an established patient;

            · Not to be reported if the non face-to-face service ends with a
            decision to see the patient within 24 hours or at a next available urgent
            visit appointment;

            · Not to be reported if non face-to-face service refers to an
            assessment and management service performed and reported by the physician or
            non-physician within the previous seven days or within the postoperative
            period of a previously completed service; and,

            · Not to be reported if another telephone or online E/M service has
            been reported in the previous seven days.

            Coding for Online Visits:

            The codes to be used for online E/M services are:

            · 99444 Online assessment and evaluation by a physician to an
            established patient, guardian, or health care provider not originating from
            a related E/M service provided within the previous seven days, using the
            Internet or similar electronic communication network.

            · 98969 Online assessment and service provided by a qualified
            non-physician health care professional to an established patient, guardian,
            or health care provider not originating from a related assessment and
            management service provided within the previous seven days, using the
            Internet or similar electronic communications network.

            Note: The CPT code description implies that this service could be used to
            communicate with another health care provider about a patient, but there is
            no evidence at this time to indicate that an insurer would pay for this
            service.



            Documenting an Online Visit:

            Feedback from patients who have used online services is overwhelmingly
            positive. Most online consultations are far more structured than a simple
            e-mail. If insurance companies are expected to pay the bill, physicians need
            documentation of the event, including diagnosis and (some say) time spent.

            Examples:

            CPT 99444 An established patient, traveling out of town on business,
            e-mails her physician for the onset of fever, cough and other cold-type
            symptoms. In the subsequent e-mail exchange, the physician reviews the
            interval history, diagnosed a bacterial infection, prescribed an antibiotic
            from a drugstore near the patient, suggested rest and recommended the
            patient contact him again in 10 days if not better. No office visit is
            required at this time. The e-mail communication is kept as part of the
            patient's medical record.

            CPT 98969 A 51-year-old male sends an e-mail message to the PA two
            weeks after an office visit with the PA for new onset of shoulder pain,
            during which an x-ray was normal and the PA advised conservative measures.
            In the e-mail, the patient notes no improvement of his symptoms. In the
            subsequent e-mail exchange, the PA reviews the interval history, advises a
            change in anti-inflammatory medications, initiates a set of mobilization
            exercises using education materials and a Web-based video, and recommends
            that the patient contact him again in two weeks for possible MRI and
            physical therapy referral if not improved. No office visit is required.

            When documenting these services, the entire event should be included,
            remembering that it is an established E/M service. Therefore, two of the
            three key components of an E/M service (e.g., history, exam, medical
            decision making) should be recorded.

            Payment for Online Services:

            Non-payment by most health plans has been a major roadblock for expansion of
            the virtual office. Since some of the major insurers are now covering the
            service, however, it is expected that more will follow. Unfortunately, some
            smaller insurers that began paying for online consultations recently stopped
            doing so because few members used the service.

            Pricing for the service varies, but should typically equate to your fee for
            a 99212 or 99213. When determining your fee, you want the fee to reflect the
            fact that you may have two or three related e-mails to complete the "visit",
            but you'll be billing it all as one service.

            Just as fees vary, so does payment. Aetna and Cigna payment range from $26
            to $32, depending upon geographic areas and individual contracts. Some pilot
            projects with Kaiser Permanente have reimbursed as high as $50/visit.

            The Medicare program is still on the sidelines when it comes to payment. It
            is considered a non-covered item, however, as opposed to a bundled service,
            so Medicare beneficiaries can be billed directly for this service. The same
            is true of Blue Shield of California. Anthem (Blue Cross of California)
            submits the service for medical review and then typically denies it for
            medical necessity, but if the patient has signed a waiver prior to
            participating in the service, you may be allowed to bill the patient
            directly.

            Getting the Word Out:

            If your practice offers online consultations/services, your patients need to
            know it! A few ways to get the word out include:

            · Announcement in monthly billing statements

            · Announcement on practice Web site

            · Article in practice newsletter

            · Mass mailing to targeted patient base

            o Give instructions for use

            § What is appropriate for e-mail

            § What conditions or requests should not be addressed by e-mail

            § Who can use (ESTABLISHED patients only - those who have been seen within
            a given period of time)

            § The expected wait time for a response

            § Whether or not you are using a secure e-mail system

            o Give instructions for sign up (if needed)

            o Give instructions for accessing

            · Recording on practice communication (telephone) system

            Summary

            Providing access for a virtual visit is a concept every family physician
            should consider. It satisfies the patients' thirst for timely access to care
            and allows them to conveniently communicate with you - whether from home or
            work, regardless of the time of day. This type of information exchange
            allows them to describe their problem and formulate their questions without
            feeling rushed. And because they have your response in writing, they can
            reread the information as often as they like or need to understand the
            content.

            This is a valuable service than can be offered to patients. But, don't give
            it away - it is an add-on service that should be priced appropriately and
            billed to either insurance or the patient.

            For more information on e-visits access:

            "Not Billing for these Services Can Cost Your Practice Revenue," CAFP's
            Practice Management News, November 2007 http://www.familydocs.org/

            AAFP Family Practice Management, October 2007; www.aapf.org/fpm

            Information Week, May 31, 2004; http://www.informationweek.com/





            Linda Walker

            Practice Managers Resource & Networking Community
            <http://www.billerswebsite.com> http://www.billerswebsite.com
            A division of K&L Media, LLC
            <http://www.klmediallc.com> http://www.klmediallc.com

            Website Design & Management for the Medical Services Industry







            From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com]
            On Behalf Of Ms V
            Sent: Tuesday, July 01, 2008 11:20 AM
            To: MedicalBillers@yahoogroups.com
            Subject: Re: [MedicalBillers] Email OV and Consults



            Does this service qualify for payment via telehealth reimbursement?

            Viola Roberts
            Mid-Atlantic Healthcare Solutions
            www.midatlantic-solutions.org
            The "Pieces of the Puzzle" experts!

            --- On Tue, 7/1/08, Terry Pierce <tpierce301@...
            <mailto:tpierce301%40yahoo.com> > wrote:
            From: Terry Pierce <tpierce301@... <mailto:tpierce301%40yahoo.com> >
            Subject: Re: [MedicalBillers] Email OV and Consults
            To: MedicalBillers@yahoogroups.com <mailto:MedicalBillers%40yahoogroups.com>

            Date: Tuesday, July 1, 2008, 11:09 AM

            Hi Deb, the online evaluation is found on page 432 of the 2008 CPT
            profesional version, it reads:

            "An on-line electronic medical evaluation is a non face to face assessment
            and management service by a qualified health care professional to a patient
            using Internet resources in response to a patient's on line inquiry.

            Reportable services involve permanent storage electonic or hard copy of the
            encounter. This service is reported only once for the same episode of care
            during a seven day period, although multiple qualified health care
            professional could report their exchange with the same patient.

            If the online medical evaluation refers to an assessment and managment
            service previously performed an reported by the qualified health care
            professional within the previous seven days (either qualified health care
            professional requested or unsolicited patient follow-up) or wihin the
            postoperative period of the previously completed procedure, then the service
            are considered covered by the previous assessment and management office
            service or procedure. A reportable service encompasses the sum of
            communciation (e.g. related telehpone calls, prescription provsion,
            laboratory order) pertaining to the on-line patient encounter.

            For an online medical evaluation provied by a physician use 99444

            98969 On-line assessment and management service provided by a qualified
            nonphysican health care professional to an established patient, guardian, or
            health care provider not originatinting from a related assessment and
            management service provided within the previous 7 days, using the internet
            or similar electronic communicatiuons network.

            Do not report 98969 when using 99339-993340, 99374,99380 for the same
            comminucations

            Do not report 98969 for anticoagulation management when reporting 99363,
            99364

            Terry J. Pierce, CPC

            ----- Original Message ----

            From: debbie brosnan <thebiller_2000@ yahoo.com>

            To: MedicalBillers@ yahoogroups. com

            Sent: Monday, June 30, 2008 4:14:20 PM

            Subject: [MedicalBillers] Email OV and Consults

            Does anyone remember reading or seeing information on this subject? Or has
            anyone attempted to bill for an Email OV? If so how did you do it and did
            you get paid?? I am trying to remember where I read about this subject in
            the recent past..

            Have a great day

            Deb

            [Non-text portions of this message have been removed]

            [Non-text portions of this message have been removed]











            [Non-text portions of this message have been removed]





            [Non-text portions of this message have been removed]
          • Terry Pierce
            I am not sure as we do not bill for this code (it s a joke around here that it s an OIG hot button code!!) I found a website that may shed some light, but
            Message 5 of 8 , Jul 1, 2008
            • 0 Attachment
              I am not sure as we do not bill for this code (it's a joke around here that it's an OIG hot button code!!) I found a website that may shed some light, but again I am not sure, sorry.
              http://www.ctel.org/index.html
               Terry J. Pierce, CPC



              ----- Original Message ----
              From: Ms V <viola_rrob@...>
              To: MedicalBillers@yahoogroups.com
              Sent: Tuesday, July 1, 2008 11:20:24 AM
              Subject: Re: [MedicalBillers] Email OV and Consults


              Does this service qualify for payment via telehealth reimbursement?

              Viola Roberts
              Mid-Atlantic Healthcare Solutions
              www.midatlantic- solutions. org
              The "Pieces of the Puzzle" experts!

              --- On Tue, 7/1/08, Terry Pierce <tpierce301@yahoo. com> wrote:
              From: Terry Pierce <tpierce301@yahoo. com>
              Subject: Re: [MedicalBillers] Email OV and Consults
              To: MedicalBillers@ yahoogroups. com
              Date: Tuesday, July 1, 2008, 11:09 AM

              Hi Deb, the online evaluation is found on page 432 of the 2008 CPT profesional version, it reads:

              "An on-line electronic medical evaluation is a non face to face assessment and management service by a qualified health care professional to a patient using Internet resources in response to a patient's on line inquiry.

              Reportable services involve permanent storage electonic or hard copy of the encounter. This service is reported only once for the same episode of care during a seven day period, although multiple qualified health care professional could report their exchange with the same patient.

              If the online medical evaluation refers to an assessment and managment service previously performed an reported by the qualified health care professional within the previous seven days (either qualified health care professional requested or unsolicited patient follow-up) or wihin the postoperative period of the previously completed procedure, then the service are considered covered by the previous assessment and management office service or procedure. A reportable service encompasses the sum of communciation (e.g. related telehpone calls, prescription provsion, laboratory order) pertaining to the on-line patient encounter.

              For an online medical evaluation provied by a physician use 99444

              98969 On-line assessment and management service provided by a qualified nonphysican health care professional to an established patient, guardian, or health care provider not originatinting from a related assessment and management service provided within the previous 7 days, using the internet or similar electronic communicatiuons network.

              Do not report 98969 when using 99339-993340, 99374,99380 for the same comminucations

              Do not report 98969 for anticoagulation management when reporting 99363, 99364

              Terry J. Pierce, CPC

              ----- Original Message ----

              From: debbie brosnan <thebiller_2000@ yahoo.com>

              To: MedicalBillers@ yahoogroups. com

              Sent: Monday, June 30, 2008 4:14:20 PM

              Subject: [MedicalBillers] Email OV and Consults

              Does anyone remember reading or seeing information on this subject? Or has anyone attempted to bill for an Email OV? If so how did you do it and did you get paid?? I am trying to remember where I read about this subject in the recent past..

              Have a great day

              Deb

              [Non-text portions of this message have been removed]

              [Non-text portions of this message have been removed]











              [Non-text portions of this message have been removed]






              [Non-text portions of this message have been removed]
            • Ms V
              Great info! Thanks to the both of you! Viola Roberts Mid-Atlantic Healthcare Solutions www.midatlantic-solutions.org The Pieces of the Puzzle experts! ...
              Message 6 of 8 , Jul 1, 2008
              • 0 Attachment
                Great info!

                Thanks to the both of you!

                Viola Roberts
                Mid-Atlantic Healthcare Solutions
                www.midatlantic-solutions.org
                The "Pieces of the Puzzle" experts!


                --- On Tue, 7/1/08, Lin <italiandoll1967@...> wrote:
                From: Lin <italiandoll1967@...>
                Subject: RE: [MedicalBillers] Email OV and Consults
                To: MedicalBillers@yahoogroups.com
                Date: Tuesday, July 1, 2008, 11:33 AM











                Aetna and Cigna are paying but with guidelines. Here is a good overview of

                the guidelines in an article:



                http://www.familydo cs.org/news- media/practice- management- news.php



                Practice Management News



                ·News + Media <http://www.familydo cs.org/main- sections/ news-media>



                GOOD NEWS FOR THE VIRTUAL OFFICE VISIT:

                HEALTH PLANS ARE BEGINNING TO PAY!

                May 2008



                Web-based doctor visits are increasing in popularity, and patients and

                providers alike express appreciation for the convenience of this type of

                encounter. One major challenge, however, has been payment. While CPT had

                developed a code for non-face-to- face visits, many plans would not pay for

                them. Recently, several plans have recognized the value in the service. In

                fact, since the beginning of 2008, Aetna Inc., the country's largest

                insurer, and Cigna, have agreed to pay physicians for online visits. Experts

                expect other large health plans to follow suit.



                Online visits typically cost the same as a regular office visit and are

                aimed primarily at those who already have a doctor (i.e., established

                patient visits). They are best for follow-up consultations and treatment of

                minor ailments such as colds and sore throats.



                Although face-to-face doctor visits will always be needed, the recent moves

                are evidence that long-delayed efforts to bring American medicine into the

                digital age may be gaining momentum, experts say.



                "Paying doctors to do more patient care over the Internet is a small but

                important step in a good direction," said David Cutler, a Harvard University

                health care economist. "It increases patient access and could significantly

                improve their satisfaction. "1 Time spent with a physician is a great

                predictor of patient satisfaction.



                Why Offer Online (Virtual) Services?



                Offering your patients access to Web-based services is useful for many

                reasons. While online services may not be face-to-face, they are considered

                direct patient contact and a great value when patients consider time with

                their physician. In addition:



                1. It has been shown that office visits can be reduced by 25 percent by

                using online communication with patients. This allows more time with

                existing appointments, as well as the possibility for a few more open

                appointment slots.



                1. Virtual visits are an opportunity for enhanced payment.



                Guidelines for Non Face-to-Face Services:



                The 2008 edition of CPT established codes for online Evaluation and

                Management (E/M) services provided by both physician and non-physician

                providers. Along with these codes came guidelines for provision of the

                service and use of the code(s):



                · Service provided by a physician or non-physician to the patient at

                the request of the patient or guardian of patient;



                · Patient is required to be an established patient;



                · Not to be reported if the non face-to-face service ends with a

                decision to see the patient within 24 hours or at a next available urgent

                visit appointment;



                · Not to be reported if non face-to-face service refers to an

                assessment and management service performed and reported by the physician or

                non-physician within the previous seven days or within the postoperative

                period of a previously completed service; and,



                · Not to be reported if another telephone or online E/M service has

                been reported in the previous seven days.



                Coding for Online Visits:



                The codes to be used for online E/M services are:



                · 99444 Online assessment and evaluation by a physician to an

                established patient, guardian, or health care provider not originating from

                a related E/M service provided within the previous seven days, using the

                Internet or similar electronic communication network.



                · 98969 Online assessment and service provided by a qualified

                non-physician health care professional to an established patient, guardian,

                or health care provider not originating from a related assessment and

                management service provided within the previous seven days, using the

                Internet or similar electronic communications network.



                Note: The CPT code description implies that this service could be used to

                communicate with another health care provider about a patient, but there is

                no evidence at this time to indicate that an insurer would pay for this

                service.



                Documenting an Online Visit:



                Feedback from patients who have used online services is overwhelmingly

                positive. Most online consultations are far more structured than a simple

                e-mail. If insurance companies are expected to pay the bill, physicians need

                documentation of the event, including diagnosis and (some say) time spent.



                Examples:



                CPT 99444 An established patient, traveling out of town on business,

                e-mails her physician for the onset of fever, cough and other cold-type

                symptoms. In the subsequent e-mail exchange, the physician reviews the

                interval history, diagnosed a bacterial infection, prescribed an antibiotic

                from a drugstore near the patient, suggested rest and recommended the

                patient contact him again in 10 days if not better. No office visit is

                required at this time. The e-mail communication is kept as part of the

                patient's medical record.



                CPT 98969 A 51-year-old male sends an e-mail message to the PA two

                weeks after an office visit with the PA for new onset of shoulder pain,

                during which an x-ray was normal and the PA advised conservative measures.

                In the e-mail, the patient notes no improvement of his symptoms. In the

                subsequent e-mail exchange, the PA reviews the interval history, advises a

                change in anti-inflammatory medications, initiates a set of mobilization

                exercises using education materials and a Web-based video, and recommends

                that the patient contact him again in two weeks for possible MRI and

                physical therapy referral if not improved. No office visit is required.



                When documenting these services, the entire event should be included,

                remembering that it is an established E/M service. Therefore, two of the

                three key components of an E/M service (e.g., history, exam, medical

                decision making) should be recorded.



                Payment for Online Services:



                Non-payment by most health plans has been a major roadblock for expansion of

                the virtual office. Since some of the major insurers are now covering the

                service, however, it is expected that more will follow. Unfortunately, some

                smaller insurers that began paying for online consultations recently stopped

                doing so because few members used the service.



                Pricing for the service varies, but should typically equate to your fee for

                a 99212 or 99213. When determining your fee, you want the fee to reflect the

                fact that you may have two or three related e-mails to complete the "visit",

                but you'll be billing it all as one service.



                Just as fees vary, so does payment. Aetna and Cigna payment range from $26

                to $32, depending upon geographic areas and individual contracts. Some pilot

                projects with Kaiser Permanente have reimbursed as high as $50/visit.



                The Medicare program is still on the sidelines when it comes to payment. It

                is considered a non-covered item, however, as opposed to a bundled service,

                so Medicare beneficiaries can be billed directly for this service. The same

                is true of Blue Shield of California. Anthem (Blue Cross of California)

                submits the service for medical review and then typically denies it for

                medical necessity, but if the patient has signed a waiver prior to

                participating in the service, you may be allowed to bill the patient

                directly.



                Getting the Word Out:



                If your practice offers online consultations/ services, your patients need to

                know it! A few ways to get the word out include:



                · Announcement in monthly billing statements



                · Announcement on practice Web site



                · Article in practice newsletter



                · Mass mailing to targeted patient base



                o Give instructions for use



                § What is appropriate for e-mail



                § What conditions or requests should not be addressed by e-mail



                § Who can use (ESTABLISHED patients only - those who have been seen within

                a given period of time)



                § The expected wait time for a response



                § Whether or not you are using a secure e-mail system



                o Give instructions for sign up (if needed)



                o Give instructions for accessing



                · Recording on practice communication (telephone) system



                Summary



                Providing access for a virtual visit is a concept every family physician

                should consider. It satisfies the patients' thirst for timely access to care

                and allows them to conveniently communicate with you - whether from home or

                work, regardless of the time of day. This type of information exchange

                allows them to describe their problem and formulate their questions without

                feeling rushed. And because they have your response in writing, they can

                reread the information as often as they like or need to understand the

                content.



                This is a valuable service than can be offered to patients. But, don't give

                it away - it is an add-on service that should be priced appropriately and

                billed to either insurance or the patient.



                For more information on e-visits access:



                "Not Billing for these Services Can Cost Your Practice Revenue," CAFP's

                Practice Management News, November 2007 http://www.familydo cs.org/



                AAFP Family Practice Management, October 2007; www.aapf.org/ fpm



                Information Week, May 31, 2004; http://www.informat ionweek.com/



                Linda Walker



                Practice Managers Resource & Networking Community

                <http://www.billersw ebsite.com> http://www.billersw ebsite.com

                A division of K&L Media, LLC

                <http://www.klmedial lc.com> http://www.klmedial lc.com



                Website Design & Management for the Medical Services Industry



                From: MedicalBillers@ yahoogroups. com [mailto:MedicalBillers@ yahoogroups. com]

                On Behalf Of Ms V

                Sent: Tuesday, July 01, 2008 11:20 AM

                To: MedicalBillers@ yahoogroups. com

                Subject: Re: [MedicalBillers] Email OV and Consults



                Does this service qualify for payment via telehealth reimbursement?



                Viola Roberts

                Mid-Atlantic Healthcare Solutions

                www.midatlantic- solutions. org

                The "Pieces of the Puzzle" experts!



                --- On Tue, 7/1/08, Terry Pierce <tpierce301@yahoo. com

                <mailto:tpierce301% 40yahoo.com> > wrote:

                From: Terry Pierce <tpierce301@yahoo. com <mailto:tpierce301% 40yahoo.com> >

                Subject: Re: [MedicalBillers] Email OV and Consults

                To: MedicalBillers@ yahoogroups. com <mailto:MedicalBill ers%40yahoogroup s.com>



                Date: Tuesday, July 1, 2008, 11:09 AM



                Hi Deb, the online evaluation is found on page 432 of the 2008 CPT

                profesional version, it reads:



                "An on-line electronic medical evaluation is a non face to face assessment

                and management service by a qualified health care professional to a patient

                using Internet resources in response to a patient's on line inquiry.



                Reportable services involve permanent storage electonic or hard copy of the

                encounter. This service is reported only once for the same episode of care

                during a seven day period, although multiple qualified health care

                professional could report their exchange with the same patient.



                If the online medical evaluation refers to an assessment and managment

                service previously performed an reported by the qualified health care

                professional within the previous seven days (either qualified health care

                professional requested or unsolicited patient follow-up) or wihin the

                postoperative period of the previously completed procedure, then the service

                are considered covered by the previous assessment and management office

                service or procedure. A reportable service encompasses the sum of

                communciation (e.g. related telehpone calls, prescription provsion,

                laboratory order) pertaining to the on-line patient encounter.



                For an online medical evaluation provied by a physician use 99444



                98969 On-line assessment and management service provided by a qualified

                nonphysican health care professional to an established patient, guardian, or

                health care provider not originatinting from a related assessment and

                management service provided within the previous 7 days, using the internet

                or similar electronic communicatiuons network.



                Do not report 98969 when using 99339-993340, 99374,99380 for the same

                comminucations



                Do not report 98969 for anticoagulation management when reporting 99363,

                99364



                Terry J. Pierce, CPC



                ----- Original Message ----



                From: debbie brosnan <thebiller_2000@ yahoo.com>



                To: MedicalBillers@ yahoogroups. com



                Sent: Monday, June 30, 2008 4:14:20 PM



                Subject: [MedicalBillers] Email OV and Consults



                Does anyone remember reading or seeing information on this subject? Or has

                anyone attempted to bill for an Email OV? If so how did you do it and did

                you get paid?? I am trying to remember where I read about this subject in

                the recent past..



                Have a great day



                Deb



                [Non-text portions of this message have been removed]



                [Non-text portions of this message have been removed]



                [Non-text portions of this message have been removed]



                [Non-text portions of this message have been removed]


























                [Non-text portions of this message have been removed]
              • debbie brosnan
                Would these two carriers pay outside of the contract? I dont believe this cpt code was encluded in our orginial contract. For here in Michigan only Blue Care
                Message 7 of 8 , Jul 1, 2008
                • 0 Attachment
                  Would these two carriers pay outside of the contract? I dont believe this cpt code was encluded in our orginial contract. For here in Michigan only Blue Care Network is paying this. Regular Blue Cross of Michigan will not. What about Medicare? Anyone having any luck with this? are they also charging a copay?

                  Lin <italiandoll1967@...> wrote: Aetna and Cigna are paying but with guidelines. Here is a good overview of
                  the guidelines in an article:

                  http://www.familydocs.org/news-media/practice-management-news.php

                  Practice Management News

                  ·News + Media <http://www.familydocs.org/main-sections/news-media>

                  GOOD NEWS FOR THE VIRTUAL OFFICE VISIT:
                  HEALTH PLANS ARE BEGINNING TO PAY!
                  May 2008

                  Web-based doctor visits are increasing in popularity, and patients and
                  providers alike express appreciation for the convenience of this type of
                  encounter. One major challenge, however, has been payment. While CPT had
                  developed a code for non-face-to-face visits, many plans would not pay for
                  them. Recently, several plans have recognized the value in the service. In
                  fact, since the beginning of 2008, Aetna Inc., the country's largest
                  insurer, and Cigna, have agreed to pay physicians for online visits. Experts
                  expect other large health plans to follow suit.

                  Online visits typically cost the same as a regular office visit and are
                  aimed primarily at those who already have a doctor (i.e., established
                  patient visits). They are best for follow-up consultations and treatment of
                  minor ailments such as colds and sore throats.

                  Although face-to-face doctor visits will always be needed, the recent moves
                  are evidence that long-delayed efforts to bring American medicine into the
                  digital age may be gaining momentum, experts say.

                  "Paying doctors to do more patient care over the Internet is a small but
                  important step in a good direction," said David Cutler, a Harvard University
                  health care economist. "It increases patient access and could significantly
                  improve their satisfaction."1 Time spent with a physician is a great
                  predictor of patient satisfaction.

                  Why Offer Online (Virtual) Services?

                  Offering your patients access to Web-based services is useful for many
                  reasons. While online services may not be face-to-face, they are considered
                  direct patient contact and a great value when patients consider time with
                  their physician. In addition:

                  1. It has been shown that office visits can be reduced by 25 percent by
                  using online communication with patients. This allows more time with
                  existing appointments, as well as the possibility for a few more open
                  appointment slots.

                  1. Virtual visits are an opportunity for enhanced payment.

                  Guidelines for Non Face-to-Face Services:

                  The 2008 edition of CPT established codes for online Evaluation and
                  Management (E/M) services provided by both physician and non-physician
                  providers. Along with these codes came guidelines for provision of the
                  service and use of the code(s):

                  · Service provided by a physician or non-physician to the patient at
                  the request of the patient or guardian of patient;

                  · Patient is required to be an established patient;

                  · Not to be reported if the non face-to-face service ends with a
                  decision to see the patient within 24 hours or at a next available urgent
                  visit appointment;

                  · Not to be reported if non face-to-face service refers to an
                  assessment and management service performed and reported by the physician or
                  non-physician within the previous seven days or within the postoperative
                  period of a previously completed service; and,

                  · Not to be reported if another telephone or online E/M service has
                  been reported in the previous seven days.

                  Coding for Online Visits:

                  The codes to be used for online E/M services are:

                  · 99444 Online assessment and evaluation by a physician to an
                  established patient, guardian, or health care provider not originating from
                  a related E/M service provided within the previous seven days, using the
                  Internet or similar electronic communication network.

                  · 98969 Online assessment and service provided by a qualified
                  non-physician health care professional to an established patient, guardian,
                  or health care provider not originating from a related assessment and
                  management service provided within the previous seven days, using the
                  Internet or similar electronic communications network.

                  Note: The CPT code description implies that this service could be used to
                  communicate with another health care provider about a patient, but there is
                  no evidence at this time to indicate that an insurer would pay for this
                  service.

                  Documenting an Online Visit:

                  Feedback from patients who have used online services is overwhelmingly
                  positive. Most online consultations are far more structured than a simple
                  e-mail. If insurance companies are expected to pay the bill, physicians need
                  documentation of the event, including diagnosis and (some say) time spent.

                  Examples:

                  CPT 99444 An established patient, traveling out of town on business,
                  e-mails her physician for the onset of fever, cough and other cold-type
                  symptoms. In the subsequent e-mail exchange, the physician reviews the
                  interval history, diagnosed a bacterial infection, prescribed an antibiotic
                  from a drugstore near the patient, suggested rest and recommended the
                  patient contact him again in 10 days if not better. No office visit is
                  required at this time. The e-mail communication is kept as part of the
                  patient's medical record.

                  CPT 98969 A 51-year-old male sends an e-mail message to the PA two
                  weeks after an office visit with the PA for new onset of shoulder pain,
                  during which an x-ray was normal and the PA advised conservative measures.
                  In the e-mail, the patient notes no improvement of his symptoms. In the
                  subsequent e-mail exchange, the PA reviews the interval history, advises a
                  change in anti-inflammatory medications, initiates a set of mobilization
                  exercises using education materials and a Web-based video, and recommends
                  that the patient contact him again in two weeks for possible MRI and
                  physical therapy referral if not improved. No office visit is required.

                  When documenting these services, the entire event should be included,
                  remembering that it is an established E/M service. Therefore, two of the
                  three key components of an E/M service (e.g., history, exam, medical
                  decision making) should be recorded.

                  Payment for Online Services:

                  Non-payment by most health plans has been a major roadblock for expansion of
                  the virtual office. Since some of the major insurers are now covering the
                  service, however, it is expected that more will follow. Unfortunately, some
                  smaller insurers that began paying for online consultations recently stopped
                  doing so because few members used the service.

                  Pricing for the service varies, but should typically equate to your fee for
                  a 99212 or 99213. When determining your fee, you want the fee to reflect the
                  fact that you may have two or three related e-mails to complete the "visit",
                  but you'll be billing it all as one service.

                  Just as fees vary, so does payment. Aetna and Cigna payment range from $26
                  to $32, depending upon geographic areas and individual contracts. Some pilot
                  projects with Kaiser Permanente have reimbursed as high as $50/visit.

                  The Medicare program is still on the sidelines when it comes to payment. It
                  is considered a non-covered item, however, as opposed to a bundled service,
                  so Medicare beneficiaries can be billed directly for this service. The same
                  is true of Blue Shield of California. Anthem (Blue Cross of California)
                  submits the service for medical review and then typically denies it for
                  medical necessity, but if the patient has signed a waiver prior to
                  participating in the service, you may be allowed to bill the patient
                  directly.

                  Getting the Word Out:

                  If your practice offers online consultations/services, your patients need to
                  know it! A few ways to get the word out include:

                  · Announcement in monthly billing statements

                  · Announcement on practice Web site

                  · Article in practice newsletter

                  · Mass mailing to targeted patient base

                  o Give instructions for use

                  § What is appropriate for e-mail

                  § What conditions or requests should not be addressed by e-mail

                  § Who can use (ESTABLISHED patients only - those who have been seen within
                  a given period of time)

                  § The expected wait time for a response

                  § Whether or not you are using a secure e-mail system

                  o Give instructions for sign up (if needed)

                  o Give instructions for accessing

                  · Recording on practice communication (telephone) system

                  Summary

                  Providing access for a virtual visit is a concept every family physician
                  should consider. It satisfies the patients' thirst for timely access to care
                  and allows them to conveniently communicate with you - whether from home or
                  work, regardless of the time of day. This type of information exchange
                  allows them to describe their problem and formulate their questions without
                  feeling rushed. And because they have your response in writing, they can
                  reread the information as often as they like or need to understand the
                  content.

                  This is a valuable service than can be offered to patients. But, don't give
                  it away - it is an add-on service that should be priced appropriately and
                  billed to either insurance or the patient.

                  For more information on e-visits access:

                  "Not Billing for these Services Can Cost Your Practice Revenue," CAFP's
                  Practice Management News, November 2007 http://www.familydocs.org/

                  AAFP Family Practice Management, October 2007; www.aapf.org/fpm

                  Information Week, May 31, 2004; http://www.informationweek.com/

                  Linda Walker

                  Practice Managers Resource & Networking Community
                  <http://www.billerswebsite.com> http://www.billerswebsite.com
                  A division of K&L Media, LLC
                  <http://www.klmediallc.com> http://www.klmediallc.com

                  Website Design & Management for the Medical Services Industry

                  From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com]
                  On Behalf Of Ms V
                  Sent: Tuesday, July 01, 2008 11:20 AM
                  To: MedicalBillers@yahoogroups.com
                  Subject: Re: [MedicalBillers] Email OV and Consults

                  Does this service qualify for payment via telehealth reimbursement?

                  Viola Roberts
                  Mid-Atlantic Healthcare Solutions
                  www.midatlantic-solutions.org
                  The "Pieces of the Puzzle" experts!

                  --- On Tue, 7/1/08, Terry Pierce <tpierce301@...
                  <mailto:tpierce301%40yahoo.com> > wrote:
                  From: Terry Pierce <tpierce301@... <mailto:tpierce301%40yahoo.com> >
                  Subject: Re: [MedicalBillers] Email OV and Consults
                  To: MedicalBillers@yahoogroups.com <mailto:MedicalBillers%40yahoogroups.com>

                  Date: Tuesday, July 1, 2008, 11:09 AM

                  Hi Deb, the online evaluation is found on page 432 of the 2008 CPT
                  profesional version, it reads:

                  "An on-line electronic medical evaluation is a non face to face assessment
                  and management service by a qualified health care professional to a patient
                  using Internet resources in response to a patient's on line inquiry.

                  Reportable services involve permanent storage electonic or hard copy of the
                  encounter. This service is reported only once for the same episode of care
                  during a seven day period, although multiple qualified health care
                  professional could report their exchange with the same patient.

                  If the online medical evaluation refers to an assessment and managment
                  service previously performed an reported by the qualified health care
                  professional within the previous seven days (either qualified health care
                  professional requested or unsolicited patient follow-up) or wihin the
                  postoperative period of the previously completed procedure, then the service
                  are considered covered by the previous assessment and management office
                  service or procedure. A reportable service encompasses the sum of
                  communciation (e.g. related telehpone calls, prescription provsion,
                  laboratory order) pertaining to the on-line patient encounter.

                  For an online medical evaluation provied by a physician use 99444

                  98969 On-line assessment and management service provided by a qualified
                  nonphysican health care professional to an established patient, guardian, or
                  health care provider not originatinting from a related assessment and
                  management service provided within the previous 7 days, using the internet
                  or similar electronic communicatiuons network.

                  Do not report 98969 when using 99339-993340, 99374,99380 for the same
                  comminucations

                  Do not report 98969 for anticoagulation management when reporting 99363,
                  99364

                  Terry J. Pierce, CPC

                  ----- Original Message ----

                  From: debbie brosnan <thebiller_2000@ yahoo.com>

                  To: MedicalBillers@ yahoogroups. com

                  Sent: Monday, June 30, 2008 4:14:20 PM

                  Subject: [MedicalBillers] Email OV and Consults

                  Does anyone remember reading or seeing information on this subject? Or has
                  anyone attempted to bill for an Email OV? If so how did you do it and did
                  you get paid?? I am trying to remember where I read about this subject in
                  the recent past..

                  Have a great day

                  Deb

                  [Non-text portions of this message have been removed]

                  [Non-text portions of this message have been removed]

                  [Non-text portions of this message have been removed]

                  [Non-text portions of this message have been removed]






                  [Non-text portions of this message have been removed]
                • Lin
                  I believe since the code is fairly new you can negotiate with the carrier, best to call them ahead of time. Linda Walker Practice Managers Resource &
                  Message 8 of 8 , Jul 1, 2008
                  • 0 Attachment
                    I believe since the code is fairly new you can negotiate with the carrier,
                    best to call them ahead of time.





                    Linda Walker

                    Practice Managers Resource & Networking Community
                    <http://www.billerswebsite.com> http://www.billerswebsite.com
                    A division of K&L Media, LLC
                    <http://www.klmediallc.com> http://www.klmediallc.com

                    Website Design & Management for the Medical Services Industry







                    From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com]
                    On Behalf Of debbie brosnan
                    Sent: Tuesday, July 01, 2008 11:59 AM
                    To: MedicalBillers@yahoogroups.com
                    Subject: RE: [MedicalBillers] Email OV and Consults



                    Would these two carriers pay outside of the contract? I dont believe this
                    cpt code was encluded in our orginial contract. For here in Michigan only
                    Blue Care Network is paying this. Regular Blue Cross of Michigan will not.
                    What about Medicare? Anyone having any luck with this? are they also
                    charging a copay?

                    Lin <italiandoll1967@... <mailto:italiandoll1967%40yahoo.com> > wrote:
                    Aetna and Cigna are paying but with guidelines. Here is a good overview of
                    the guidelines in an article:

                    http://www.familydocs.org/news-media/practice-management-news.php

                    Practice Management News

                    ·News + Media <http://www.familydocs.org/main-sections/news-media>

                    GOOD NEWS FOR THE VIRTUAL OFFICE VISIT:
                    HEALTH PLANS ARE BEGINNING TO PAY!
                    May 2008

                    Web-based doctor visits are increasing in popularity, and patients and
                    providers alike express appreciation for the convenience of this type of
                    encounter. One major challenge, however, has been payment. While CPT had
                    developed a code for non-face-to-face visits, many plans would not pay for
                    them. Recently, several plans have recognized the value in the service. In
                    fact, since the beginning of 2008, Aetna Inc., the country's largest
                    insurer, and Cigna, have agreed to pay physicians for online visits. Experts
                    expect other large health plans to follow suit.

                    Online visits typically cost the same as a regular office visit and are
                    aimed primarily at those who already have a doctor (i.e., established
                    patient visits). They are best for follow-up consultations and treatment of
                    minor ailments such as colds and sore throats.

                    Although face-to-face doctor visits will always be needed, the recent moves
                    are evidence that long-delayed efforts to bring American medicine into the
                    digital age may be gaining momentum, experts say.

                    "Paying doctors to do more patient care over the Internet is a small but
                    important step in a good direction," said David Cutler, a Harvard University
                    health care economist. "It increases patient access and could significantly
                    improve their satisfaction."1 Time spent with a physician is a great
                    predictor of patient satisfaction.

                    Why Offer Online (Virtual) Services?

                    Offering your patients access to Web-based services is useful for many
                    reasons. While online services may not be face-to-face, they are considered
                    direct patient contact and a great value when patients consider time with
                    their physician. In addition:

                    1. It has been shown that office visits can be reduced by 25 percent by
                    using online communication with patients. This allows more time with
                    existing appointments, as well as the possibility for a few more open
                    appointment slots.

                    1. Virtual visits are an opportunity for enhanced payment.

                    Guidelines for Non Face-to-Face Services:

                    The 2008 edition of CPT established codes for online Evaluation and
                    Management (E/M) services provided by both physician and non-physician
                    providers. Along with these codes came guidelines for provision of the
                    service and use of the code(s):

                    · Service provided by a physician or non-physician to the patient at
                    the request of the patient or guardian of patient;

                    · Patient is required to be an established patient;

                    · Not to be reported if the non face-to-face service ends with a
                    decision to see the patient within 24 hours or at a next available urgent
                    visit appointment;

                    · Not to be reported if non face-to-face service refers to an
                    assessment and management service performed and reported by the physician or
                    non-physician within the previous seven days or within the postoperative
                    period of a previously completed service; and,

                    · Not to be reported if another telephone or online E/M service has
                    been reported in the previous seven days.

                    Coding for Online Visits:

                    The codes to be used for online E/M services are:

                    · 99444 Online assessment and evaluation by a physician to an
                    established patient, guardian, or health care provider not originating from
                    a related E/M service provided within the previous seven days, using the
                    Internet or similar electronic communication network.

                    · 98969 Online assessment and service provided by a qualified
                    non-physician health care professional to an established patient, guardian,
                    or health care provider not originating from a related assessment and
                    management service provided within the previous seven days, using the
                    Internet or similar electronic communications network.

                    Note: The CPT code description implies that this service could be used to
                    communicate with another health care provider about a patient, but there is
                    no evidence at this time to indicate that an insurer would pay for this
                    service.

                    Documenting an Online Visit:

                    Feedback from patients who have used online services is overwhelmingly
                    positive. Most online consultations are far more structured than a simple
                    e-mail. If insurance companies are expected to pay the bill, physicians need
                    documentation of the event, including diagnosis and (some say) time spent.

                    Examples:

                    CPT 99444 An established patient, traveling out of town on business,
                    e-mails her physician for the onset of fever, cough and other cold-type
                    symptoms. In the subsequent e-mail exchange, the physician reviews the
                    interval history, diagnosed a bacterial infection, prescribed an antibiotic
                    from a drugstore near the patient, suggested rest and recommended the
                    patient contact him again in 10 days if not better. No office visit is
                    required at this time. The e-mail communication is kept as part of the
                    patient's medical record.

                    CPT 98969 A 51-year-old male sends an e-mail message to the PA two
                    weeks after an office visit with the PA for new onset of shoulder pain,
                    during which an x-ray was normal and the PA advised conservative measures.
                    In the e-mail, the patient notes no improvement of his symptoms. In the
                    subsequent e-mail exchange, the PA reviews the interval history, advises a
                    change in anti-inflammatory medications, initiates a set of mobilization
                    exercises using education materials and a Web-based video, and recommends
                    that the patient contact him again in two weeks for possible MRI and
                    physical therapy referral if not improved. No office visit is required.

                    When documenting these services, the entire event should be included,
                    remembering that it is an established E/M service. Therefore, two of the
                    three key components of an E/M service (e.g., history, exam, medical
                    decision making) should be recorded.

                    Payment for Online Services:

                    Non-payment by most health plans has been a major roadblock for expansion of
                    the virtual office. Since some of the major insurers are now covering the
                    service, however, it is expected that more will follow. Unfortunately, some
                    smaller insurers that began paying for online consultations recently stopped
                    doing so because few members used the service.

                    Pricing for the service varies, but should typically equate to your fee for
                    a 99212 or 99213. When determining your fee, you want the fee to reflect the
                    fact that you may have two or three related e-mails to complete the "visit",
                    but you'll be billing it all as one service.

                    Just as fees vary, so does payment. Aetna and Cigna payment range from $26
                    to $32, depending upon geographic areas and individual contracts. Some pilot
                    projects with Kaiser Permanente have reimbursed as high as $50/visit.

                    The Medicare program is still on the sidelines when it comes to payment. It
                    is considered a non-covered item, however, as opposed to a bundled service,
                    so Medicare beneficiaries can be billed directly for this service. The same
                    is true of Blue Shield of California. Anthem (Blue Cross of California)
                    submits the service for medical review and then typically denies it for
                    medical necessity, but if the patient has signed a waiver prior to
                    participating in the service, you may be allowed to bill the patient
                    directly.

                    Getting the Word Out:

                    If your practice offers online consultations/services, your patients need to
                    know it! A few ways to get the word out include:

                    · Announcement in monthly billing statements

                    · Announcement on practice Web site

                    · Article in practice newsletter

                    · Mass mailing to targeted patient base

                    o Give instructions for use

                    § What is appropriate for e-mail

                    § What conditions or requests should not be addressed by e-mail

                    § Who can use (ESTABLISHED patients only - those who have been seen within
                    a given period of time)

                    § The expected wait time for a response

                    § Whether or not you are using a secure e-mail system

                    o Give instructions for sign up (if needed)

                    o Give instructions for accessing

                    · Recording on practice communication (telephone) system

                    Summary

                    Providing access for a virtual visit is a concept every family physician
                    should consider. It satisfies the patients' thirst for timely access to care
                    and allows them to conveniently communicate with you - whether from home or
                    work, regardless of the time of day. This type of information exchange
                    allows them to describe their problem and formulate their questions without
                    feeling rushed. And because they have your response in writing, they can
                    reread the information as often as they like or need to understand the
                    content.

                    This is a valuable service than can be offered to patients. But, don't give
                    it away - it is an add-on service that should be priced appropriately and
                    billed to either insurance or the patient.

                    For more information on e-visits access:

                    "Not Billing for these Services Can Cost Your Practice Revenue," CAFP's
                    Practice Management News, November 2007 http://www.familydocs.org/

                    AAFP Family Practice Management, October 2007; www.aapf.org/fpm

                    Information Week, May 31, 2004; http://www.informationweek.com/

                    Linda Walker

                    Practice Managers Resource & Networking Community
                    <http://www.billerswebsite.com> http://www.billerswebsite.com
                    A division of K&L Media, LLC
                    <http://www.klmediallc.com> http://www.klmediallc.com

                    Website Design & Management for the Medical Services Industry

                    From: MedicalBillers@yahoogroups.com
                    <mailto:MedicalBillers%40yahoogroups.com>
                    [mailto:MedicalBillers@yahoogroups.com
                    <mailto:MedicalBillers%40yahoogroups.com> ]
                    On Behalf Of Ms V
                    Sent: Tuesday, July 01, 2008 11:20 AM
                    To: MedicalBillers@yahoogroups.com <mailto:MedicalBillers%40yahoogroups.com>

                    Subject: Re: [MedicalBillers] Email OV and Consults

                    Does this service qualify for payment via telehealth reimbursement?

                    Viola Roberts
                    Mid-Atlantic Healthcare Solutions
                    www.midatlantic-solutions.org
                    The "Pieces of the Puzzle" experts!

                    --- On Tue, 7/1/08, Terry Pierce <tpierce301@...
                    <mailto:tpierce301%40yahoo.com>
                    <mailto:tpierce301%40yahoo.com> > wrote:
                    From: Terry Pierce <tpierce301@... <mailto:tpierce301%40yahoo.com>
                    <mailto:tpierce301%40yahoo.com> >
                    Subject: Re: [MedicalBillers] Email OV and Consults
                    To: MedicalBillers@yahoogroups.com <mailto:MedicalBillers%40yahoogroups.com>
                    <mailto:MedicalBillers%40yahoogroups.com>

                    Date: Tuesday, July 1, 2008, 11:09 AM

                    Hi Deb, the online evaluation is found on page 432 of the 2008 CPT
                    profesional version, it reads:

                    "An on-line electronic medical evaluation is a non face to face assessment
                    and management service by a qualified health care professional to a patient
                    using Internet resources in response to a patient's on line inquiry.

                    Reportable services involve permanent storage electonic or hard copy of the
                    encounter. This service is reported only once for the same episode of care
                    during a seven day period, although multiple qualified health care
                    professional could report their exchange with the same patient.

                    If the online medical evaluation refers to an assessment and managment
                    service previously performed an reported by the qualified health care
                    professional within the previous seven days (either qualified health care
                    professional requested or unsolicited patient follow-up) or wihin the
                    postoperative period of the previously completed procedure, then the service
                    are considered covered by the previous assessment and management office
                    service or procedure. A reportable service encompasses the sum of
                    communciation (e.g. related telehpone calls, prescription provsion,
                    laboratory order) pertaining to the on-line patient encounter.

                    For an online medical evaluation provied by a physician use 99444

                    98969 On-line assessment and management service provided by a qualified
                    nonphysican health care professional to an established patient, guardian, or
                    health care provider not originatinting from a related assessment and
                    management service provided within the previous 7 days, using the internet
                    or similar electronic communicatiuons network.

                    Do not report 98969 when using 99339-993340, 99374,99380 for the same
                    comminucations

                    Do not report 98969 for anticoagulation management when reporting 99363,
                    99364

                    Terry J. Pierce, CPC

                    ----- Original Message ----

                    From: debbie brosnan <thebiller_2000@ yahoo.com>

                    To: MedicalBillers@ yahoogroups. com

                    Sent: Monday, June 30, 2008 4:14:20 PM

                    Subject: [MedicalBillers] Email OV and Consults

                    Does anyone remember reading or seeing information on this subject? Or has
                    anyone attempted to bill for an Email OV? If so how did you do it and did
                    you get paid?? I am trying to remember where I read about this subject in
                    the recent past..

                    Have a great day

                    Deb

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