Requirements and Best Practices

REQUIREMENTS AND RECOMMENDATIONS FOR SUCCESSFUL TELEHEALTH VISITS

• Clinician has signed the System Policy and returned to IT Dept.
• Clinician has completed all trainings and reviewed tutorials to navigate BetterPT and a telehealth visit.
• Clinician is aware that the Telehealth page on the Alliance PTP Intranet can be utilized as an ongoing resource.

• Clinician must determine that the patient and their medical concerns are appropriate for a telehealth visit.
  • Consider the need for in-person evaluation before telehealth follow-up visits.
    • If the patient is not able to attend an in-person evaluation, are they a candidate for a telehealth evaluation?
• Confirm Consent to Treat, Telehealth Consent, HIPPA and all other necessary intake forms are completed in Formstack and uploaded in Agile PM.
• Documentation in Agile similar to traditional visits but must include two “site” locations noted in the Objective section of the daily note:
  • The originating site: where the patient is located
  • The distance site: where the clinician is located
• Billing
  • Telehealth will be all self-pay at this time for Medicare/Medicaid and UHC (except CA?).
  • Clinician will utilize the Self-Pay option in Agile daily note
    • Select the appropriate service codes for telehealth
  • Per visit rate of $70 for evaluation visit
  • Per visit rate of $35 per 15 minutes for subsequent treatment visits
    • Follow the 8-minute rule for billing
      • 8-22 minute=1 unit
      • 23-37 minute=2 units
      • 38-52 minute=3 units
• Visit Wrap-Up
  • Clinician will confirm or schedule patient’s next telehealth visit
  • Notify the patient of visit cost the session and that the patient will receive a call same day from a payment specialist (FOC, rev cycle)
  • If added to HEP, inform the patient they will be receiving an email from MedBridge with an access code to obtain HEP with video instructions.
    • Document access code in Agile daily note or Clinical Notes section be able to provide ongoing additions/changes to the same HEP for the patient to utilize throughout the plan of care.

• Prior to patient starting telehealth visits
  • FOC or clinician will inform the patient what to expect and how to prepare for the visits
  • FOC will email telehealth patient info for the Telehealth Virtual Care Landing Page (when ready)
• Patient Preparation
  • Patient must have a computer, tablet or phone with internet and camera for the telehealth visits. Make sure their device is charged or plugged in.
  • Patient should be on the lookout for emails from
    • BetterPT for what to expect and preparation
    • BetterPT with the appointment time and the button to click to start the telehealth session.
  • Patient should wear comfortable clothing that the patient can easily move in and perform exercises
  • Patient should find a private space in their home away from children, pets and other distractions with ample room to move. The patient needs to make sure they can be in the location for 30 minutes or so as length of time for these sessions may vary. The patient may also need to consider placement of device with camera such as utilizing a piece of furniture that is table height so the clinician can easily view the patient performing movements and exercises.
  • Patient may need to be prepared with a yoga mat, comfortable surface to lie down or bed surface if necessary, to perform certain movements and exercises.
  • Patient may also want to have any exercise equipment (i.e. resistance bands, ball, etc.) or additional items (i.e. towel) on hand for the telehealth session.
  • Additional considerations
    • Paper and pen for taking notes
• What to Expect
  • The telehealth session is a one-on-one collaborative communication platform between the patient and clinician
  • Much like in-person physical therapy, each telehealth session may include a combination of discussion of medical history, symptoms, assessment of the body parts and systems that may be contributing to the patient’s primary complaints
  • Treatment
    • Telehealth visits can be used to guide patient through strengthening, flexibility, balance and functional mobility exercises to recover from surgery or address a variety of acute and chronic conditions.
    • Each session will be tailored to meet a patient’s individual needs

• Competence is key. Practice a run through the process prior to trying with a patient.
• Utilize advanced clinical decision making to determine how best and safely adapt clinical practice to video.
• Telehealth should be thought of as an alternative mode of delivering physical therapy services but delivering the same standards of care as in the clinic.
• Assessment and Documentation
  • Clinician will need to rely on their eyes and ears for assessment
    • Documentation of impairments such as ROM will be documented as estimated
    • Documentation of change should focus on impairments related to functional mobility deficits