How telemedicine is changing health care for practitioners and patients

By Kathy Hargreaves, CPA/CFP/CPC & Dawn Morgan, CPA

COVID has been a disrupter for change everywhere and it has permanently altered our expectations about the way physicians, and other providers, approach the delivery of health care. When the virus was recognized as a critical threat, Florida Governor Ron DeSantis issued a mandate which closed, or restricted, health care delivery for nonessential services. Dental visits and non-emergency physician office visits and surgeries were halted. Many providers were forced to close their doors. When the mandate was lifted, more than six weeks later, patients still were unwilling to venture into physician offices; even plexiglass shields and cars as waiting rooms did not entice them back. Practitioners turned to telehealth in response which encompassed services furnished via real-time, interactive communication technology to connect with their patients.

While telehealth is certainly not new, government restrictions on providers were such that most could not afford to offer it. As it became clear that patients were either unwilling or unable to go into their physician’s office, restrictions were temporarily lifted and the service became widely available. Given the appeal and convenience of telehealth to consumers, this technology is here to stay.

Savvy health care providers are now looking to up their game in the telehealth arena. Some of our healthcare consulting clients who are planning an expansion, or new office space, are mapping in telehealth rooms, and specialized equipment, while others have repurposed offices (and even closets) to accommodate the service. The government’s Health and Human Services funding was designed to support the expansion of remote technologies and many clients have taken advantage of that assistance. Most major health insurance carriers offer a form of telehealth coverage including Aetna, Florida Blue, Cigna, Humana and United Healthcare. Medicare, Part B, covers 80% of the virtual visit cost for preventative health screenings, evaluation and management visits and mental health counseling.

As with any foray into new territory, there have been lessons learned as to best practices for both patient and health care provider.

Providers have learned to utilize multiple screens so that they can see the patient, and read their charting, while simultaneously looking at the camera. They have learned to exhibit calm confidence, as patients sometimes struggle with technological challenges. While scheduling is different, missed appointments are rarer. Sometimes payment arrangements must be made, or taken over the phone, and because the reimbursement is lower than an in-office visit it is important to collect that co-pay or deductible.

Televisits are a good way to offer some form of expanded hours because of their flexibility.

Since mainstreaming telemedicine is still relatively new, there are best practices that practitioners should be aware of:

  • Advertise the service. Be bold. Patients actually want the service. Make sure it is prominently displayed on your website, along with the hours the service is available.
  • Develop written protocols and procedures. Train staff utilizing those protocols so that the service is seamlessly offered.
  • Offer written instructions before your patient’s visit to ensure they have a phone number to call for technical assistance and to advise of any specific software that must be downloaded for the visit.
  • Ensure protocols are in place, in advance, for gathering medical history and any other paperwork required for billing.

And for patients using telehealth, prepare for your appointment in advance:

  • Write down any questions you have ahead of time and be sure to document your vitals, such as weight and temperature.
  • Take photos in advance of any wounds, or injuries, that you’ll be discussing, like a healing surgery incision.
  • Have a notebook ready for taking notes about your treatment plan.

Preparing well for televisits will result in the same quality of care as the patient would enjoy in person, and they can experience that visit in the comfort of home while everyone learns new ways of getting things done in a post-COVID world.

Shareholder Kathleen A. Hargreaves, CPA/CFP/CPC and Tax Manager Dawn Morgan, CPA of KB Healthcare Consultants provide “best practice” service solutions to health care industry organizations, including all physician specialties, laboratories, hospitals and ambulatory surgery centers. The KB Healthcare team is comprised of medical consultants, accountants, certified coders and compliance specialists with focused experience in the healthcare industry. Hargreaves joined Kerkering Barberio in 1992 and was admitted as a shareholder in 1997.


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