These are some unprecedented times we are facing in the United States right now, and with the uncertainty of tomorrow, it is important that we as an acupuncture community look for new, and useful ways to stay relevant in the healthcare industry. Telehealth, while many of us may not have thought to look to it as an option as our specialty involves needling the patient, there are many options for acupuncturists in the way of telehealth services to offer patients during the pandemic and beyond.
What is Telehealth?
According to the World Health Organization (WHO), telemedicine or telehealth is “The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment, and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.”
Due to the arrival of COVID-19, there is a greater need for the use of more technological services than ever before for those who need regular care from their acupuncturist or healthcare provider. Rather than shutting down completely, having systems like a telehealth option in place would be beneficial for specialties like acupuncture to keep practices running. Additionally, telehealth services will be an added convenience for your patients increasing their access to care, keeping you & your practice in their mind when they can’t get to the office. Lastly, telehealth allows the provider to continue accepting new patients virtually, which is crucial to stay in business.
How Do I Incorporate Telehealth?
In general, incorporating telehealth into your practice requires an interactive video and audio telecommunications system between the acupuncturist and a patient. Depending on your state, they may permit telehealth encounters to be only audio if the patient is already established. However, it is important to note that just because your state may permit audio-only telehealth sessions does not mean that an insurance carrier will reimburse for it, so it is important to check with major carriers before moving forward with billing to insurance.
State requirements for telehealth:
- A patient must affirmatively consent to a telehealth visit
- Providers must meet the state requirements for licensure and scope of practice for telehealth
- Must be documented no differently than a face-to-face visit
Another factor with incorporating telehealth is making sure you clear with how telehealth will work, and making your patients feel comfortable with this new method. For many patients, telehealth is a new method of healthcare, and certainly a new way of seeing their acupuncturist. The process at first can be intimidating and interesting at the same time so they will have a lot of questions.
Questions patients will have about telehealth:
- How is my visit/health information kept secure?
- How will my visit work?
- How is my privacy protected?
- Do I need a special device to attend a telehealth visit?
Many patients just want to be sure they have the same security and privacy that they would have in an exam room at the in-person appointment. Having the proper tools and technology in place is the cornerstone of answering these questions, and giving a clear picture of how their telehealth visit will run.
Essential technology for Acupuncturists offering telehealth:
- Reliable and secure internet connection
- Video and audio function
- Custom-configured hardware & tools – the key hardware includes, desktop/laptop computers, and tablets. The tools include things that are very similar to ones that would be available in a face-to-face visit such as vital sign monitors. There are also specific cameras available for different types of specialties.
- Custom software – Electronic Medical Records (EMR) provides a digital patient record, and keeps patient data encrypted to ensure security & privacy. There are many companies that have software that can be customized to meet the needs of the acupuncturist.
All tools used must be HIPAA (Health Insurance Portability and Accountability Act) compliant to protect the patient’s right to privacy. It is best to check with your state to see what telehealth tools are HIPAA compliant for your state. While ACE does not endorse specific products or companies, there are some telehealth platforms that have been used most commonly amongst general practitioners and/or acupuncturists. As always, make sure to do your own due diligence and research when searching for a telehealth solution for your practice.
Telehealth platform options:
- Mend NOW Telehealth
In regards to finding the right one for you and your acupuncture practice, it is important to ask yourself, and possibly the telehealth platform, the proper questions.
Questions for a telehealth platform:
- Is there a waiting room feature?
- Is there an out-of-office message noting when I am not available?
- Does the software have the ability to schedule a visit?
- Is the platform able to use a wide range of devices? (this is so that acupuncturists and patients alike can use a device of their choosing for virtual care)
- Can I exit my contract at any time?
Making sure all of your questions are answered and fit your goals for providing telehealth is a key start to a successful telehealth service option.
Acupuncture & Telehealth
The question on your mind may be simple, “what can I offer my patients at home as an acupuncturist?”
Acupuncturist telehealth visit options:
- Dietary/lifestyle recommendations
- Herbal consultation/prescription
- Treatment plan (which can include the above)
- Acupressure points to maintain treatment at home
- Tongue analysis/consultation
The whole purpose of adding telehealth to your practice is to provide patients with access to continued holistic care, and to maintain on-going dialogue with their acupuncturist. Telehealth can be especially helpful for patients who need on-going assistance managing their chronic pain, or issues that they, under circumstances such as COVID-19, would not get help for. Herbal consultations, however, are not a service covered by insurance, so billing would not be offered for this service. As we said earlier, it is important to check with any major insurance carrier to see what would and would not be covered in regards to telehealth acupuncture.
CPT Codes for Telehealth:
- 99441 – for an established patient, for up to 7 days, cumulative time during the 7 days; 5 – 10 minutes
- 99442 – for an established patient, for up to 7 days, cumulative time during the 7 days; 11 – 20 minutes
- 99443 – for an established patient, for up to 7 days, cumulative time during the 7 days; 21 – 30 minutes
Essentially, a telehealth visit is somewhat of an extended Evaluation & Management (E&M) visit where you have a discussion with the patient about the history of their issue, evaluating their outcome, and what they can do at home. It is important to document these codes properly just as you would for a face-to-face encounter. In addition to different codes, the place of service would also be different. In the office the place of service is 11, however, with telemedicine visits, you will need to change the place of service to 02 if you are able to bill out to insurance for the services you have provided virtually. If you do have a new patient, they will need to come in for at least a one-time visit before moving onto a telehealth session, although, it is important to note that this may differ from state to state.
Telehealth for Acupuncturists
While at first glance the idea of implementing telehealth into your acupuncture practice may seem daunting, the truth is that software companies in addition to other acupuncturist resources make it fairly easy to do. Telehealth services, even if it is not something you want to implement on a permanent basis, is an amazing tool to have in your back pocket for such occasions as something like COVID-19 or times when your patients just simply cannot come to the office. Below you will find resources for you to look up information about your specific state as well as some telehealth resources specifically geared toward acupuncturists.
Technology is moving and growing daily, and it is important for us as acupuncturists to stay ahead of the game to remain relevant. At the end of the day, implementing telehealth will allow you to be the person for your patients that gives them a feeling of calm and assurance in an uncertain time, which is always what we want as their provider.
Telehealth rules by state: https://www.ama-assn.org/system/files/2018-10/ama-chart-telemedicine-patient-physician-relationship.pdf
Easy to use consent form for patients: https://www.ahrq.gov/health-literacy/informed-consent-telehealth.html
Telehealth resources for acupuncture & chinese medicine: https://www.pacificcollege.edu/news/blog/2020/04/13/telemedicine-for-acupuncture-and-chinese-medicine-professionals
Free webinar for acupuncture telemedicine: https://blog.lhasaoms.com/acupuncture-events/upcoming-lhasa-oms-free-webinars-tips-tricks-for-telemedicine-insurance-billing-featuring-sarit-hirschkorn/
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