If you are severely ill, one of your concerns about receiving the medical attention you need may be leaving your house. In fact, you may feel that you can’t receive help since you don’t want to go to the doctor’s office. Especially for people who are immunocompromised and elderly, physically going to a doctor’s office can feel frightening. If you have a contagious condition, you might worry about spreading your illness to others. If you are not, you may fear that you will get sick at a healthcare facility from being around other sick people. Thankfully, telemedicine and telehealth can provide addiction treatment and healthcare at home.
Telemedicine utilizes technology to give care at a separate location from their patients. A doctor in one area uses a telecommunications infrastructure to provide care for a patient in another place. However, telehealth’s scope is broader. Basically, telehealth refers to electronic and telecommunication technologies that provide all types of care and services from a distance.
History of Telehealth
Although telehealth has only begun to include videoconferencing within the last decade, telehealth has gone on for much longer. For example, doctors have been visiting their patients at their bedside rather than in an office for centuries. Further, remote visits began in the 1950s, around when home phones began gaining popularity. Now, doctors have the flexibility to Zoom, Skype, or FaceTime patients. Even though they’re not in an office together, they’re still face-to-face.
We want to help people from Oklahoma discover what telehealth and telemedicine options are available to them. We want to help you understand how and why telemedicine has expanded in 2020, how you can use telehealth, and how telehealth can give you a new option for addiction treatment. If you have any questions or would like to learn more about telehealth, please call us at 405-583-4390.
Studies on Telemedicine and COVID-19
Current studies and literature reviews support the idea that telemedicine and telehealth can help during this pandemic. For example, one study published by the Journal of Telemedicine and Telecare explains how important telemedicine is. The study states the following:
“For people not infected with the COVID-19 virus, especially those at higher risk of being affected (e.g. older adults with pre-existing medical conditions), telehealth can provide convenient access to routine care without the risk of exposure in a congested hospital or in medical practice waiting rooms.”
Although the review points out how effective telehealth can be, it recognizes conditions for its effectiveness. For instance, medical professionals need to be willing to adjust how they offer care. Additionally, healthcare providers will need extra funds to that carrying out telehealth services effectively is possible. Finally, the healthcare industry as a whole needs to adjust to telehealthcare. Each of these steps will enable telehealth to effectively provide quality service to patients.
As COVID-19 has progressed in 2020, government programs have adapted and have made telehealth and telemedicine more possible. In this way, the healthcare industry has had the resources to effectively respond to COVID-19. As the disease has progressed, medical professionals have responded and adapted.
Will Medicare or Medicaid Cover my Telemedicine Costs?
If you are considering telehealth or telemedicine, it can be hard to know if Medicaid or Medicare will cover your treatment. Without coverage, it can be hard to afford costs. Fortunately, if you are enrolled in Medicare or Medicaid, your insurance will likely cover telehealth costs. Generally, if Medicare or Medicaid deems the service necessary, then they will be able to cover it. If you want to know the specific guidelines, you need to know about the expansion of the telehealth waiver.
Expansion of Telehealth Waiver
On March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) passed a waiver. This waiver makes telehealth more accessible for those enrolled in Medicare. Ultimately, the waiver makes it clear that CMS “has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility.” Medicare will fully pay for the three types of services via telehealth according to this waiver:
Importantly, many other providers such as nurse practitioners, doctors, clinical psychologists, and clinical social workers can provide telehealth appointments with their patients as well. Additionally, the HHS Office of Inspector (OIG) now gives more flexibility to providers. OIG can reduce or waive cost-sharing for telehealth visits due to this increased flexibility. This is because federal healthcare programs have paid for them, reducing their cost.
Services are another important part of insurance to consider. Services covered by Medicaid will need to fit in with the federal requirements. These requirements call for three things: efficiency, economy, and quality of care. Basically, these requirements encourage states to pay for telemedicine services consistently. For example, a state program could reimburse costs for doctor visits, technical support, transmission charges, and equipment.
Medicaid and Telemedicine
Ultimately, telemedicine provides a cost-effective, contact free alternative to traditional, face-to-face healthcare. States can choose if they will provide Medicaid coverage for telehealthcare because it is cheaper. It is important to note that states determine where they will cover telemedicine within the state’s regions. Further, states also decide what types of telemedicine providers may be covered or reimbursed. Finally, states choose how much to reimburse for telemedicine services. All they need to do is to stay within the Federal Upper Limits. Each state handles telemedicine coverage differently, so use the state’s website to find more information.
Oklahoma and Telemedicine
Oklahoma provides telehealth to its residents through several different organizations. One of these organizations, the Telehealth Alliance of Oklahoma (TAO), is an Oklahoma state nonprofit. The organization recently put out a statement that compared telehealth usage between March and June 2019 to telehealth use between March and June 2020. In 2019, 6,989 members used telehealth services. In 2020, however, that number jumped to 78,545. Additionally, 2019’s average refund per member was $140. This year, it was $307. Further, last year physicians conducted 11,941 telehealth visits. In 2020, they conducted 337,415 visits. Finally, the total cost for visits last year was $975,000. This year, the cost rose to $24 million. Clearly, Oklahomans are utilizing telehealth services much more than they were last year. To learn more about telehealth available in Oklahoma, please visit this website.
Will my Insurance Cover Telehealth Addiction Treatment?
For those of you who do not receive healthcare through Medicare or Medicaid, you might Also, you may receive coverage through one of the Big Five. The Big Five includes BCBS, Signa, United Healthcare, Aetna, and Humana. These carriers all provide telehealth services in some form. However, telehealth is normally listed as a policy-dependent medical service. This means that receiving coverage for the service depends on what kind of policy you have. For example, someone with a more expensive gold plan will likely have access to telemedicine. However, someone who has the more cost-effective bronze plan likely doesn’t. If you’re not sure whether your plan covers telehealth, you will need to call your provider.
What to Do When You Call Your Insurance Provider
Here are some tips for how to prepare for and call your provider. Before you call, prepare a list of questions. Also, have a notepad ready to jot down answers when you receive them. Here is a basic outline of the types of questions you can ask:
- What is this call’s reference number?
- Does my policy include telehealth services?
- If so, what do telehealth services include?
- Should I use a specific billing code?
- Are there any limitations or restrictions for this service? Is coverage limited to a few times a year?
- To access telehealth services, do I need any special documentation from a doctor?
The reason you need a reference number is that you will later have evidence to prove your case should you need it. Additionally, your representative should be able to answer questions and clarify your issues with coverage. Having questions prepared, a notebook ready, and your reference number handy can help you succeed in having a productive conversation with your provider.
Does Telehealth Addiction treatment work?
We all have expectations about what addiction treatment will look like. For example, you may picture traveling for addiction treatment and enrolling in an inpatient or residential program. Also, you may feel that finding a community with others is an important part of the recovery process. When you think about treatment, you may think of spending time outside or having group therapy sessions. You may even picture doing equine therapy or yoga. Clearly, telehealth addiction treatment might not match up with the picture of addiction treatment you have created in your mind. However, addiction treatment through telehealth can be both effective and beneficial in important ways.
Telehealth programs allow patients to meet virtually with their clinicians through videoconferencing. With the help of a clinician, they can treat their addiction through medication and therapy. This method helps people who suffer from substance use disorders as well as mental health disorders. A 2011 literature review worked to measure the effectiveness of telehealth rehab centers. Of the 50 studies the researchers reviewed, 76% reported that participants found satisfaction from their care. These participants supported telemedicine fully. This high percentage shows that you can trust telemedicine to treat your addiction.
It is important to note that the study also found that sustained participation in telemedicine presented some challenges. Most studies reviewed reported the evidence of clinical effectiveness. Therefore, the authors of the literature review agreed that more researchers should conduct studies in the future.
The Opioid Crisis and Telehealth
Importantly, some programs offer treatments specifically for those who suffer from opioid addictions. Several studies examined psychotherapy treatments as well as medication treatments. Many of these studies found that interventions and treatment via telehealth to be effective, just like the literature review from 2011. One of the studies, published by the American Journal on Addicts, examined the retention of 177 patients who received buprenorphine treatments through telemedicine. The medication buprenorphine helps reverse the effects of opioid addiction. The study found that after one week of treatment, 98% of the patients had stayed active. After one month, 91% of patients had stayed active. Finally 57% of patients had stayed active at three months. Out of the percentage of patients who stayed active during all three months, 86% of them had an opioid-negative urine toxicology. Based on these positive results, researchers determined that buprenorphine treatment via telemedicine can be successful. If you are struggling with an opioid addiction, telemedicine is a legitimate option for recovery.
Especially during a pandemic, finding telehealth options for addiction treatment can help many people. If you live in Oklahoma and you or a loved one suffers from a substance use disorder, we can help. Please call us today at 405-583-4390.