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Is My Doctor Online? Enabling Telehealth Through Provider Directory Accuracy

Associate Vice President, Vertical Solutions Consultants

As the United States faces the growing COVID-19 health crisis, the delivery of healthcare is changing rapidly – particularly regarding the use of telehealth. In March, telehealth visits were up 50% and are expected to hit 1 billion this year. Beyond that, the number of physicians offering telehealth services is growing.

For instance, looking at the time period from January of this year to March, the number of family health physicians offering telehealth has grown from 3,286 to 79,523 – that’s more than a 2300% increase in mere months.[i] Healthcare organizations, and those vendors who support them, have an opportunity to facilitate this growth in usage by making it easy for patients to find providers to meet their needs.

Telehealth Reduces Exposure for High-risk Populations

One of the biggest contributors to the recent boom in telehealth usage is CMS’ expansion of access to and reimbursement for services. By incentivizing the use of telehealth visits, both patients and providers can help to minimize the spread of coronavirus.

Patients who have the virus can remain in isolation, while those uninfected can minimize their exposure. Telehealth also provides a way to lessen the stress of exposure for high-risk or immune-compromised populations who may need routine follow up care or general medical attention, but are afraid to seek it in person.

The new Medicare telehealth rules that have emerged from the current situation include:

  • Lifting location limits.
    Telehealth services may be provided in urban or rural regions, and may be conducted in patient homes, nursing or assisted living facility, or other non-medical facilities.
  • Adding more eligible providers.
    Eligible providers (physicians, nurses, dieticians, PAs, psychologists, LCSW) may begin billing for telehealth services on 3/6/2020. Facilities may not bill for telehealth.
  • Expanding the type of covered services.
    Telehealth services may be for COVID- or non-COVID-related services, including emergency department visits, initial nursing facility and discharge visits, home health visits, and therapy sessions.
  • Dropping prior relationship audits.
    CMS will not verify whether patients have had an ongoing relationship with their telehealth provider.
  • More telephone options.
    CMS will allow telehealth services to be conducted by telephones with “audio and video capabilities that are used for two-way, real-time interactive communication” (e.g. smartphones).

Accurate Directories Are Critical to Enable Virtual Care

As the new CMS guidelines point out, there are no longer restrictions on which physicians a patient can contact when requiring telehealth services. Patients are not limited to providers with whom they have a pre-existing relationship, or who are located close by. They can seek services for any provider who is eligible to conduct virtual appointments.

However, when feeling unwell, most patients would prefer to speak to the physician who knows them and knows their medical history. Healthcare organizations can help by focusing on updating their provider directories more regularly.

In normal, non-pandemic situations, provider data is constantly changing. It’s estimated that 2.4% of provider demographics change monthly. Now, with more and more providers offering telehealth services, and with overall types of services being expanded to virtual platform offerings, it’s more important than ever to make sure that provider directories are regularly updated to reflect capabilities, allowing patients to find out quickly if their current provider is available to meet virtually.

In this time of uncertainty, it’s often the little things that can have a lasting impact on care delivery in our country. Making care more accessible with updated provider directories may seem like a simple step, but now more than ever the ability to reach and care for patients remotely can have a positive long-term effect on outcomes. More importantly, this is a small step that can provide many people tremendous peace of mind.

Learn more about updating provider directories across the healthcare enterprise here. To learn more about our response to COVID-19, visit our resource center.

[i] LexisNexis® Risk Solutions MarketView™ data pulled 4.17.20

The DNA of Healthcare

At LexisNexis Risk Solutions, our goal is to provide the healthcare industry with insights and innovations to improve outcomes, grow market share, reduce fraud and increase compliance.

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