Do we know if Healthchoice is covering telehealth?
Coalition of Oklahoma Therapy Practices
Written by The Coalition of Oklahoma Therapy Practices
Mar 14, 2020
ATTENTION OKLAHOMA THERAPY PRACTICE OWNERS
Email [email protected] to join our coalition as we share resources and work with our insurance providers to ensure that Oklahoma children have access to therapy during this unprecedented time. MEMBERSHIP IN THE COALITION IS FREE. YOU DO NOT HAVE TO JOIN ONE THERAPY NETWORK TO BE A PART OF THIS COALITION.
Abbreviated Notes from meeting 3/13/2020
- To form a coalition of Oklahoma therapy practice owners working together
- To establish a plan
- To minimize the disruption caused by the coronavirus to our patient’s continued care and to our practices
Changes to existing practice norms
- Allow parents to wait in their car with their child and the therapist goes out to get them and then takes them back to the car.
- Removing toys from waiting rooms, limiting toys in treatment rooms to easily cleaned objects.
- Wiping down toys after every therapy session.
- For school contracts - a home program that won’t have any direct therapy (ie parental consultation). Collaborate with parents on what they can be doing with the patient.
Alternative Service Delivery Options
- PLEASE NOTE THIS MESSAGE ABOUT HIPAA LAWS BEING RELAXED TEMPORARILY:
Google Hangout Meets is looking to be the quickest and most easily adoptable option. They are offering their enterprise version with a BAA for free until 7/1. Through this platform you can share your screen, use annotation tools (with the addition of Kami), and it’s easy to get parent’s connected. You simply email them the link to the video conference. You may need to figure out a method to ensure that sessions are recorded/reported in daily notes or on their appointment to authenticate attendance? Here are some links and additional information:
- Prepare to use Hangout Meets https://cloud.google.com/blog/products/g-suite/helping-businesses-and-schools-stay-connected-in-response-to-coronavirus
- The Enterprise version of GSuites is being offered at no cost until July 1st. Google Meets is HIPAA-Compliant with the BAA, Google Hangouts is not.
- BAA (Must be in place for HIPAA-Compliance)
- I’ve tested the setup/user interfacing process on myself and it works fine. Two monitors would be most helpful when using so you can share a separate screen from the one you are running the session off of.
- Spruce Health while currently free for 2 months, does not seem to have the interactiveness offered by other platforms. It does not have the ability to share screen,annotate, etc. It also requires parents and staff to download an app and log-in via that app. May be a harder adoption for families and staff. It’s also unclear how/if patients can be shared between multiple providers. You have to set up patient accounts so more work on the front end.
- TheraPlatform is another widely used one, but you are also paying for a EMR/patient management system so if you aren’t looking to make a major change it seems like an unnecessary additional cost.
- Blink Sessions looks fantastic. Tons of read to us resources and designed specifically for therapists. HOWEVER, you must sign a 12-month agreement if you don’t sign up for their consultation services ($1200) and at 20 users the cost is $49/month (starts at $64/month with just one user and goes down as you add users). You have to go to a website to log-in.
- Zoom If anyone is considering Zoom... you have to choose the Business Plan which starts at $19.99 per host (therapist) per month with a minimum of 10 hosts (so $199 per month). However, if you choose the annual plan (which sounds like some other platforms are requiring), you can get the cost per therapist down to $16.66 per month ($400/yr savings). AND I found a code "PORTFOLIOPARTNER-ZOOM" that will take off an additional $400/yr bringing the cost per therapist down to $13.33.
Teletherapy and Insurance Providers
- Questions to Ask:
- Is Teletherapy a covered service? If so, is prior authorization required?
- Do they require location code of 02 and/or GT modifier on the Prior Authorization or the claims?
- https://www.okhca.org/providers.aspx?id=112 Here is the link announcing the new rules.
- You will need to document your therapy using the "02" POS (place of service) along with the GT modifier.
- https://www.okhca.org/providers.aspx?id=112 Here is the link announcing the new rules.
- BCBS of Oklahoma
- Kelly Godfrey and K. Kristina Egnore will reach out to BCBS of Oklahoma
- Tricare East Region -
- Cigna- Can anyone contribute to this? Email me at [email protected]
- If there are any other insurance plans explored by anyone within the Coalition, please reach back out so that all can be informed.
Federal and State Relief and Rules
- https://www.sba.gov/disaster-a... Information on low interest loans that should be available to Oklahoma business soon.
- Income Tax Deferral I just got a clip of the administration saying that tax deferrals will be available for anyone who would normally be expected to make a tax payment on April 15th. I'll find a link and post that soon.
- President Trump has mentioned there may be some loans available for small businesses; or some payroll tax exemptions, etc. Will continue to follow and report to the group.
- Friday evening the president declared a national emergency and promised substantially more federal support. He made sweeping statements about making it easier for healthcare providers to provider telemedicine. It is unclear what, if any, impact this has on our specific situation.
- Late Friday night the US house passed a bill aimed to help families affected by the coronavirus. There are several parts to the bill but below are the items that will potentially affect practice owners:
- establish a federal emergency paid leave benefits program to provide payments to employees taking unpaid leave due to the coronavirus outbreak,
- expand unemployment benefits and provide grants to states for processing and paying claims,
- require employers to provide paid sick leave to employees
- In addition, the bill requires the Occupational Safety and Health Administration to issue an emergency temporary standard that requires certain employers to develop and implement a comprehensive infectious disease exposure control plan to protect health care workers.
Other Resources Available
- https://www.theinformedslpmembers.com/free-telepractice-research-reviews Our friends at The Informed SLP have put together a ton of great information about teletherapy.
- Speechpathology.com and some courses you can take specific to teletherapy; ASHA has some on their site as well. Will share the link for these. (https://www.asha.org/Practice-Portal/Professional-Issues/Telepractice/)
- AOTA has 2 CEU classes available (Kelly Godfrey)
- On FB - Telepractice group; those who have been doing for years are giving some good advice. Stacy Kaut will add to chat what she found. (https://www.facebook.com/events/2881936075260599/)
- Form a coalition so we can refer to ourselves as a group when we’re trying to get movement. Name: Coalition of Oklahoma Therapy Practices.
- Choose point of contact for billing questions: Edwin Brown ([email protected], cell: 601-624-1237)
- Choose point of contact for clinical questions: Kelly Hawkins ([email protected])
- Choose point of contact for government liaison: Emily Hathaway ([email protected])
- Call local representatives as a constituent of serving kids in their area re OHCA movement (Emily Hathaway / Ken Hathaway). Encourage ALL to do this!!
- http://www.oklegislature.gov/FindMyLegislature.aspx Use this tool to find the elected legislator for your personal address and your practice address. You are both a citizen and a business owner.
- Tell them "I need your help in getting OHCA to meet with The Coalition of Oklahoma Therapy Practices to discuss our proposal to easily allow therapy practices to continue serving the children of Oklahoma during this unprecedented time. Their phone number is 601-624-1237."
- Consider having your patients, staff, and any one else you can think of to call their legislator as well.
- Pam Mayer (Colorado) suggested we reach out to our STAR (ASHA representative in OK working on their behalf). Emily Hathaway will run point for this contact. Pam will send her the Oklahoma contact’s name.
- Sarah SVA will reach out to the insurance commissioner.
Members of the Coalition
(if you want to join the coalition, please email [email protected])
Sarah VanAlstine: OKOTA (Oklahoma Occupational Therapy Association)
Edwin Brown: One Therapy Network
Kelly Hawkins: Therapitas
Monica Benear: Innovative Therapy
Maggie Vincent: Communication Station
Lorraine Auchter: Sensational Kids
Paula Lewis and Liz Hylton: Quest Pediatric Therapies
Emily Hathaway: Speech Pathway
Diane Holland: Holland Pediatric Therapy
Jessie Carr: Therapitas Tulsa
Kelly Godfrey: Therapy 4 Kids
Shannon Roberson: Total Poss-Abilities
Nicole Stull & Liz Bomhoff: Today's Therapy Solutions
Greta Worthington and Aileen Sadler: Gore Therapy Center
Stacey Taylor: Taylor'd Therapy Services
Christa Collins: OKC Speech LLC
Kristina Egnor: Therapy Specialists
Farinam Pletka: Therapitas
Abby O'Dell: Advanced Therapy Solutions
Dianna Persun: Can Do Kids Therapy
Laura Rix Robertson: Bartlesville Hope Pediatric Therapy
Colette Ellis, 29th Street Therapy Center
Cynthia Puckett, Wonderfully Made Therapy
Stephanie Valentine: Therapy Link Solutions
Jodi Jennings: Therafunction
Sue Marolf: Pathways Therapy Center
Karin Cantrell: HTR Pediatrics
Katie Aday: Aday of Speech Therapy
Karen Sturges: West Therapy
Samantha Prater: Empowering Life Therapy
Kassie Peck: Greenhouse Pediatric Therapy
Shelly Geddes: Pediatric Communication Solutions, Inc
Kris Siegenthaler: Impact Rehab and Wellness
Delana Turnipseed: Elite Therapy
Larry and Jessica Sang: Imagine Pediatric
Becky Payne: The SPOT for Kids
Kim Knapp and Karin Cantrell: HTR Pediatrics
Karlie Collins: Chris King Counseling
Patty Daniel: Onward and Upward
Jennifer Pennington and Kelly Davis: Effective Communication LLC
Tabetha Mathiesen: Wholistic Therapy
Barbara Moreira: Ready Set Go Children's Therapy Center
Tara Kirby: Wonderfully Made Therapy
I'm glad to hear that update from @Abby O'Dell. I spoke with Rep. Kendra Horn today and she told me that she was aware of the challenge with insurance companies and that she was learning news as quickly as we are. Rep. Horn advised me to contact the Oklahoma Insurance Department.
I spoke with Liz Heigle at the Oklahoma Insurance Department who is in communication with Glen Mulready, the Oklahoma Insurance Commissioner. We spoke about whom to contact from BCBS OK and other Oklahoma insurance companies to get them to issue a statement about telehealth for Oklahomans that have been mandated to stay in their homes and avoid public places. They took my information, have already emailed me, and also said they would call me back. No update yet.
I did leave a message with Sen. Greg Treat.
I did leave a message with Rep. Denise Crosswhite-Hader.
I am drafting a few templates for folks to use as business owners and another for parents to use with their representatives. It will be ready soon.
Our biller Spoke with a BCBS rep yesterday who stated they were informed by their administration yesterday that telehealth can be provided even if not a registered telehealth provider. Must be a HIPAA compliant system. Not specific on what would be covered in regards to type of service rendered. She stated that stated all provider types and most services (labs, PT, etc not covered due to need for physical contact). She stated that provisions are being added due to COVID-19 to allow any services that don't require physical contact to be provided via telehealth for BCBS. Specific information specifically that speech therapy services will be covered is not available, however she stated "If it can be provided reasonably via telehealth not requiring physical contact they are allowing it via telehealth at this time." She stated specific guidelines or written information stating this information not available at this time.
She stated that our PNC could possibly provide written guidelines and statement when available and that they are working on it. We are continuing to look into this and in hopes to get more specific information and details in writing.
Abby, that's great news. Let us know if you get your hands on something in writing.
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