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Virtual Visits: How Telehealth In Florida During COVID-19 Is Being Used, Covered By Insurance

The number of telehealth visits through the Memorial Healthcare System through March and April of this year have increased by 662 percent, compared to televisits for all of last year.
The number of telehealth visits through the Memorial Healthcare System through March and April of this year have increased by 662 percent, compared to televisits for all of last year.

If you've needed to talk to your doctor since the pandemic started, it's likely been by video conference call. 

The transition to virtual visits has been an adjustment not just for patients but for hospitals, and health insurers, too. 

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Memorial Healthcare System in Broward County, says the number of telehealth visits through March and April this year have increased by 662 percent, over all of last year. That requires infrastructure and educating providers, as well as patients using the programs for the first time. WLRN spoke with the Administrative Director of Telehealth Strategy for Memorial Healthcare, Bill Manzie. He represented hospitals on the state's former Telehealth Advisory Council. The council's research was incorporated into a 2019 lawestablishing standards of care for telehealth providers in Florida. 

 

The council has since disbanded, but Manzie says the members have stayed in touch during the pandemic, to share some telehealth best practices with their communities.   

 

The following conversation has been edited for length and clarity. 

WLRN: Telehealth visits are where patients are meeting with their doctors online through video conferencing. What kinds of appointments work in a tele-visit versus what do you really need to be in the office to see your doctor for?MANZIE: It really is up to the professional, to determine what is appropriate and what isn't. I specifically say providers, because it isn't just for physicians — nutritionists, rehab therapists, physicians, nurses. We've had a chaplain use telehealth.

Definitely anything that needs hands on, definitely anything that requires some sort of testing.Telehealth shouldn't be used for emergencies. If you're a cardiac patient and you feel that you're having an emergency, you'd always want to go to the [emergency room] or an urgent care center first.

Where telehealth shines is, it augments that. So if you are a cardiac patient and you're just not feeling well, then you can use telehealth to connect to your physician who can guide you on whether or not your medication may need to be changed or your dosage needs to be changed or if you need to go into the E.R., or just into the office. 

What are some of those best practices for telehealth?

We really had to look at, where can we best use the telehealth technology to meet the needs of our patients? How do we educate these patients now who were so used to going in the office for all these years, now having to do everything virtually? And they may not have known what telehealth was. 

As we open up, we're instructing our providers — if your patient does not need to be in the office, try to see them as us through telehealth as much as possible. That reduces exposure.

Surgeries are starting to come up again. Because family members can't come in as a visitor with the patient, we are going to connect with them through telehealth before the surgery and after the surgery to give them updates and to let them know what is happening to a loved one here at the hospital.

I myself recently had a telehealth doctor visit and without my health insurance retroactively going back to reprocess claims because of the pandemic, my costs would have jumped from twenty five dollars to more than four hundred dollars for one visit. And I guess I just wonder, why are some virtual visits more expensive for patients?

So I don't know of that specific example where it would be more money. However, It shouldn't be any more expensive than as if you're paying for it through insurance.

What should patients do if they find themselves getting charged a strange rate for a virtual visit during this pandemic?

Patients who are unsure on whether or not their insurance covers that, they really need to reach out to their insurance company. All insurance companies have their own internal regulations regarding telehealth and reimbursement for telehealth, and that varies.

It's something that many, many other states are...mandating, reimbursement. There is no reason why we couldn't do it here in Florida. And quite frankly, it still surprises me that it isn't a mandate. But with that being said, it really is something that the patient would need to reach up to their insurer for. 

Read More: Coronavirus Reset: How To Get Health Insurance Now

How is your day to day working in telehealth different right now during the pandemic?

What did change is how quickly we implement programs, what types of technology we use and really thinking out of the box with our clinicians. 

Not too long ago, we had an elderly couple, a wife and a husband who were both in isolation and we used telehealth technology to bring them together during their last hours. It was really a sad story, but something that I'm really proud to be able to have provided to them during that time of need. 

But those who were in isolation and getting better, they also couldn't have family members visit them. So we had to, and we did, implement a service that allowed that, where we were able to bring in friends, family members — just bringing that love to the patient who is struggling in that room.

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