Here's How Insurance Companies are Adjusting to Coronavirus
A new day, a new hat, and several new insurance company updates! Since yesterday, there have been a couple of new developments in the insurance world since the coronavirus outbreak has continued.
Practice Solutions is committed to proactive and preventive communication about these changes so that you can make the best decisions for your practice, your staff, and the patients that you serve.
Since we are seeing changes to the insurance companies almost hourly, we will continue to provide video updates on the latest trends that we are observing as well as provide you with the links for the updates that we are seeing.
BCBS TN is offering Telehealth For FREE!
BlueCross will offer telehealth visits at no cost to members in eligible health plans now through April 30. “We know our members are concerned and taking extra precautions, so we want to offer more options for seeking care when they need it,” says Kelly Paulk, vice president of product strategy and individual markets. “They can use telehealth services for many health concerns, 24/7 and from the comfort of their home or workplace.”
This enhanced benefit is available to BlueCross members with Medicare plans, Individual/Marketplace plans and fully insured employer-based plans. Members can call the Member Service number on the back of their BlueCross ID card to find out if they’re eligible.
Members with our telehealth benefit can access PhysicianNow powered by MDLive by phone, online video chat or through the MyBlueTN mobile app.
First-time users need to register for an account on bcbst.com.
We have not heard from Beacon officially, but when we do eligibility and benefits checks the reps are saying that patients with eligible health plans are covered at in-network rates. If you are in-network with Beacon, we would encourage you to do your eligibility and benefits to make sure that they are covered.
Fox and Everett
I spoke to the folks at Fox and Everett and they are saying that at this time their patients are not going to be covered for telehealth services. If you have patients with this insurance, please do your best to advocate for them by asking for an exception in this area. We will be doing the same from our side.
States that historically have the most restrictive telehealth policies that we are watching closely are:
Florida: A new law passed last year would allow out-of-state physicians to register to provide telehealth services to Florida residents. But the state still does not require health plans to cover telehealth as a benefit, and its Medicaid programs currently only reimburse for live video telemedicine.
Idaho: Idaho’s Medicaid telehealth programs only reimburse for live video telehealth visits. But the state has recently moved to expedite licensing for physicians who want to practice in multiple states.
Ohio: In Ohio, telehealth session reimbursement could be lowered from regular sessions.
Pennsylvania: Lawmakers in Pennsylvania have been hammering out legislation to address Covid-19, including expanding telehealth. Currently, the state doesn’t have any laws governing how payers cover the cost of telemedicine.
West Virginia: For Medicaid to pay for a telehealth visit in West Virginia, it must take place at one of a handful of “originating sites”, including a physician’s office or a rural health clinic. This doesn't really help the social distancing recommendations from top health officials.
Wisconsin: Wisconsin currently doesn’t have any laws in place governing how telehealth is covered or paid for by private insurers. Its Medicaid program limits reimbursement to video visits but does cover at-home visits. We heard from a client today that said that Right now, Wisconsin Medicaid won't allow the client to be in their home for the telehealth session. They have to be at an originating site which somewhat defeats the purpose.
Mental health and substance abuse services provided in home or community settings are the same BadgerCare Plus and Medicaid-reimbursable mental health and substance abuse outpatient services as described in Wis. Admin. Code §§ DHS 107.13(2) and (3), but the services are provided in the home or community. These services include evaluations, psychotherapy, and substance abuse counseling. Services must be provided by Medicaid-enrolled mental health or substance abuse clinics. In addition, psychiatrists or Ph.D. psychologists in private practice may provide services.
"Home or community" is defined as those settings that are therapeutically necessary for the member (e.g., a person's home or senior citizen center). Therapeutic reasons must be documented to show that the setting is necessary, as required in Wis. Admin. Code ch. DHS 35.