As part of Independence?s commitment to providing superior access to care,
we are introducing a new telemedicine strategy for 2016. As the modern digital
revolution continues, Independence is creating the opportunity for convenient,
effective, and affordable health care solutions via digitized channels and
virtual experiences. We are committed to expanding access to primary care,
while addressing the diverse needs of our members, ensuring they receive
quality health care services at affordable prices.
In the spectrum of care available to members, Independence considers
telemedicine to be an option that enhances access for members, as does our
network of retail health clinics and urgent care centers. Therefore,
Independence is offering various telemedicine options for members when they
otherwise may not be able to see a provider in person. It is important to note
that the telemedicine solutions described below are not intended to replace the
member?s relationship with their primary care provider. For emergencies,
members should continue to be directed to the nearest emergency room/department
(ER).
Outlined below is Independence?s approach to telemedicine for our commercial
members.
Telemedicine for primary care
As introduced in the December 2015 edition of Partners in Health
UpdateSM, Independence now covers telemedicine encounters for
our commercial members seeking primary care serv ices from primary care
providers (family medicine, internal medicine, general medicine and pediatric
med icine) who offer telemedicine services as an additional method of delivery.
These encounters allow our members to interact with primary care providers
using a HIPAA-secure audio/visual system that allows members and providers to
see and hear one another in real time. For specific coverage information,
please review Claim Payment Policy #00.10.41: Telemedicine for Primary Care
Services, which is available on our Medical Policy Portal. Select
Accept and Go to Medical Policy Online, and then the Commercial
tab from the top of the page. Type the policy name or number in the Search
field.
Benefits include:
- Gives primary care providers the ability to communicate with their patients
in the event that an in-person encounter is not possible.
- Provides a more cost-effective option than visiting an ER, retail health
clinic, or urgent care center for non-emergency medical conditions.
- Offers care after normal business hours, including nights, weekends, and
even holidays (availability may vary).
National vendor telemedicine solution
Independence has contracted with MDLIVE®, a national vendor
that connects individuals to board-certified primary care physicians via
HIPAA-secure video, telephone, or mobile app 24/7/365. These physicians can
diagnose medical conditions, provide short-term treatment plans, and may
prescribe medications for non-emergency medical conditions. The member can get
information on physician profiles, check appo intment availability, and
schedule an appointment with the physician of their choice. The member may
request a copy of the medical records from these telemedicine encounters to
share with their primary care provider. Note: This program is available
only to certain commercial members dependi ng upon their plan benefits and
employer group. Members should check their benefits handbook to verify el
igibility for this service.
Benefits include:
- Provides alternate care options for non-emergency medical conditions when
it?s not possible to visit an ER, retail health clinic, or urgent care
center.
- Allows members to access non-emergency medical care while traveling*.
*Due to state regulations, telemedicine services are not
available in the state of Arkansas.
JeffConnect
This Pilot Program is currently available to Independence employees and
their dependents, and allows members to connect with emergency medicine
physicians from Jefferson University Physicians, Jefferson Medical Care, or
Methodist Associates in Healthcare (Jefferson) 24/7/365 via a HIPPA-secure
video conference on a smartphone, tablet, or camera-equipped computer.
Proper utilization
Telemedicine improves access to care but does not always replace an
in-person visit with a physician. Here are some examples of when it?s
appropriate to utilize telemedicine:
- As an alternative for the ER, retail health clinic, or urgent care center
for a non-emergency medical issue. Some ideal situations for utilizing
telemedicine include: allergies, asthma, colds, ear infections, rashes, insect
bites, sinus infections, sore throats, and urinary tract infections.
- To request a prescription, when appropriate. Members utilizing telemedicine
can obtain prescriptions for non-narcotic medications (not controlled
substances) that in most cases can be sent directly to the pharmacy of their
choice.
- When it is not convenient to leave home or work.
As telemedicine continues to evolve and expand and as the technology
improves, Independence will keep you up to date with relevant changes to our
policies and benefits. If you have any questions, please contact your Network
Coordinator.