A-Z about Telemedicine and Insurance

The rapid increase in COVID-19 made US authorities and insurers look for alternatives to provide safe care to the patients at their homes. They were looking for an alternative approach that makes health care accessible to all, without overburdening the emergency departments and healthcare centers. Hence, the need to provide healthcare to the citizens of the US. While maintaining social distancing to reduce the exposure of coronavirus led to a significant rise in Telemedicine or Telehealth.

What is Telemedicine?

Telemedicine is a practice that allows people to access health-related services via the electronic mode of communication and telecommunications. The healthcare professional can evaluate, diagnose, and treat people at distance. The common technology used by them is videoconferencing and remote patient monitoring. However, one must note that Telemedicine is not a new concept but it did get a boost amidst pandemic. Furthermore, the federal government, state government, healthcare providers, and insurance companies are making necessary changes required in the existing healthcare system.

List of Services provided in Telemedicine

There are numerous health care services are covered under telemedicine.  Here is the list of common conditions that a doctor can treat under this service:

• Allergies
• Arthritis pain
• Asthma
• Bronchitis
• Cold and flu 
• Diarrhea
• Infection
• Insect Bite
• Pharyngitis
• Rashes
• Conjunctivitis
• Respiratory Infection
• Vomiting
• Sinusitis
• Skin inflammation
• Sprains and Strains
• Sore throat
• Bladder infection
• And UTIs 

 How did the outbreak of pandemics change things? 

According to research, Telemedicine was initially used by the National Aeronautics and Space Association (NASA) in 1960 in the mission Project Mercury to monitor the medical conditions of astronauts. In the field of neurology and radiology, telemedicine services are very useful. This niche model of healthcare service came into the mainstream after the outburst of COVID-19. According to a recent poll, 23% of adults have used this service in the pandemic. Moreover, the federal government and state government are working in the direction to include telemedicine in insurance.

US Governments efforts to expand Telemedicine

The Federal government has loosened the restrictions allowing states to shape their own rules and regulation for coverage in state-regulated insurance plans and Medicaid. The changes in the regulation are temporary to facilitate telehealth. Meanwhile, the government is making an action plan for the long term. Thus, keeping this in mind the US government is also investing in the development of infrastructure and making sure that health workers can manage this increase in telemedicine visits. Hence, the government introduced some policies to facilitate telehealth in response to coronavirus.

• Health Insurance Portability and Accountability Act (HIPAA)

All telemedicine platforms are required to follow the regulations set under Health Insurance Portability and Accountability Act (HIPAA). This act allows Services like FaceTime and Skype to be used for telemedicine, even if it is not related to covid-19. 

• MEDICARE

The Federal government waived certain restrictions on Medicare coverage of telehealth services. The beneficiaries of medical can receive telehealth service in any Geographic area. It allows telehealth services to be accessed by real-time audio or video interaction. Besides this, they also removed the requirement for the pre-existing relationship between the patient and the provider. The providers have the ability to waive or reduce the cost of sharing telehealth services. Additionally, Medicare provides reimbursement for telehealth services and also pay a facility fee to the originating site. 

• Private Insurance Provider

After seeing the popularity in telemedicine private payers are paying for telemedicine services. Only 33 states and D.C. passed Telemedicine parity laws. The law makes it mandatory for private payers to pay for telemedicine services at the same rate as in-person visits. However, not all telemedicine services are equal to the onsite visits. According to Telehealth lawyer Nathan Lacktman, only 17 states have no telehealth coverage. While 12 states (and DC) have broad, consumer-friendly telehealth coverage laws. Whereas, 10 states have limited telehealth coverage. 9 states have broad coverage and also payment parity.

In conclusion, last year made it very clear that telemedicine will play a vital role in the future of healthcare. But we cannot ignore the challenges like lack of infrastructure, absence of quality care, risk of malpractice faced by both patient and the provider. Also, very few insurance providers give full coverage for telemedicine services. Therefore, the Federal and State government must take the necessary steps to change this scenario. Because access to affordable health care is the most basic human right which must be protected.

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