Can you get paid by insurance?
Yes. One of the things I learned early on was that physicians and patients are often uninformed. Most of the physicians I encountered absolutely believed you couldn’t get reimbursed for telemedicine. That is simply not true. I am credentialed by almost every private insurer. Telemedicine is also covered by Medicaid and Medicare. There are a few “special” telemedicine codes, but for the most part, coding for telemedicine is extremely similar to traditional billing and coding. I even had my billing company tell me I couldn’t get paid from certain insurance companies, however having done my research and knowing the law, I forced them to submit my claims and I was, in fact, reimbursed. Currently 21 states require private insurances to reimburse for telemedicine. Some states even require that insurances pay whatever they would pay you in office.
Is my specialty needed?
Yes. The opportunities in telemedicine are truly endless. Telemedicine is medicine. Every employer across the country (including the federal government) if not already seeking telemedicine providers, will be soon. There are tons of job postings for telemedicine and most recruiters will seek you out. Both full-time and part-time opportunities are available but many companies choose to pay physicians on a per visit basis which can generate low volume and therefore low productivity. Some physicians choose to work with multiple telemedicine employers to compensate for the low volume. As the industry continues to grow, more full-time opportunities and more salaried positions will become available. I will post a separate thread on how telemedicine can be applied to different specialties. Shifts are usually 8-12 hours. At The Rowe Network, we offer shifts of 4, 6, 8, and 12 hours.
Who should I work for?
As physicians, we assume the risk of losing our licenses when companies choose not to practice ethically so it is very important that you know who you are working for. Many telemedicine companies are not owned by physicians and many started off simply as technology companies. If the company owners are not very knowledgeable on healthcare practices and laws, you may consequently suffer from their negligence and mistakes. Some companies knowingly break the law and do not inform the patients they are doing so. If a company hires you without performing the appropriate background checks and undergoing due diligence, that should be a red flag as well. There are over 450 telemedicine companies. According to the American Telemedicine Association, there were 1.5 million virtual visits conducted during the last year alone. Always remember the telemedicine company needs you more than you need them.
This is what makes The Rowe Network different. We are 100 percent physician owned and we are against the corporate practice of medicine. We believe physicians are the best advocates for their patients and only when we are involved in every aspect of the organization, from ownership to employment, can we truly protect the patient. Every telemedicine company will have a physician on their website to draw you in. It's up to you to figure out if they are merely a figurehead or truly an integral part of the company.
Do I need special equipment?
In a nutshell, you will need a computer and secure software which will enable you to connect to your patients in a virtual room environment. There are other factors you should consider to determine your personal limitations to practicing telemedicine.
Consider your skill set. First, are you comfortable diagnosing medical problems without a physical exam? If not, then telemedicine is not for you. I realized way before I started practicing telemedicine that I didn’t need a physical exam for many of my patient complaints. I did the exam because the patient expected me to, only to confirm a diagnosis I already expected, and to meet the criteria for billing and coding. Second, can you stay put, tied to a computer for 8 to 12 hours? Some people enjoy working around others and relish in a more social atmosphere. If you are the type of person that “needs” to be in an office, telemedicine may not be the best fit for you.
Review current agreements. Does your employment present restrictions for you to work with a telemedicine company? Since telemedicine has no geographic barrier except for your license, you may be accused of violating a non-compete even if the company you work for is not physically within the same area. I suggest you have your attorney check your contract to make sure there are no specific statements or clauses that restrict your ability to work with a telemedicine company.
Will I be sued?
Telemedicine is safe. There has yet to be a hallmark case for telemedicine so whoever is the first person to be sued will probably have to pay a significant penalty. As I was told in medical school, "If you haven’t been sued, you haven’t practiced long enough.” Because of this fact, I recommend higher limits of malpractice coverage than what is traditionally accepted.
Most reputable malpractice carriers will be more than willing to extend coverage for telemedicine providers without significant cost. The visits seen online are typically low acuity so as long as you stay within the scope of your practice. Usually your employer will provide malpractice coverage, but if you are an independent contractor, make sure you cover yourself and seek appropriate limits.
Also keep in mind, unless you are licensed in a state that participates in the Physician Licensing Compact you can only see patient in the state where you reside.
Is it legal?
Telemedicine laws change daily. Do not ever rely on an employer to keep you informed. If you are not sure about the laws in your state, contact the medical board yourself and ask for clarification. If you have any concerns, most medical boards have attorneys who will answer your basic questions at no cost. Being a part of telemedicine physician forums and groups is also another great way to stay informed. Unfortunately, many traditional medical organizations are just starting to take a stand on telemedicine and are not really keeping members informed of these major changes in healthcare.
One of the many benefits of being a part of the The Rowe Network network is that we will keep you up-to-date on all of the latest news in telemedicine. To sign up for email updates, visit www.clickitclinic.com.
What else can I do to help address the problems in healthcare?
Whether you decide to practice telemedicine, invest in telemedicine, or continue to practice traditionally, we as physicians are crucial in shaping what happens from here on out. Patients, family and friends will come to you for your opinion on whether telemedicine is safe. They will ask you what to look for. They will ask you who to trust. If we sit aside and allow this industry to grow without being a part of the conversation, we will end up with a very disconnected healthcare system and there is a good chance we can be left out of the equation. There are presently six bills in Congress regarding telemedicine and crucial decisions are being made with or without us. I empower you all today to be a part of the equation.
Latisha T. Rowe, M.D., MBA, is a Board Certified Physician specailizing in Family Medicine. A pioneer in the field of telemedicine, she is the founder, principal owner and chief executive officer of Houston-based The Rowe Network. The Rowe Network provides telehealth monitoring and solutions to assist and treat patients via online video consultations following in office examinations. The Rowe Network currently services a network of over 200 physician practices.
If you are interested in joining our The Rowe Network network or learning more about our business model, email your CV to firstname.lastname@example.org.