The Health Resources Services Administration defines “telehealth as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration1.” Technologies include videoconferencing, the Internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
Telehealth is different from telemedicine because it refers to a broader scope of remote health care services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote nonclinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) recognizes telehealth as a potentially useful tool that, if employed appropriately, can provide important benefits to patients, including: increased access to health care, expanded utilization of specialty expertise, rapid availability of patient records, and lower costs for patient care. Telemedicine, when used in accordance with Blue Cross NC’s guidelines, can be an effective method for providers to communicate directly with their patients, as a means of delivering health care to our members2.
Blue Cross NC recently merged its corporate medical policies for telemedicine and e-visits, and released a new and expanded reimbursement policy addressing these types of telehealth services, as applicable to Blue Cross NC’s commercially offered products. The new telehealth policy was effective in July 2015 and explains guidelines for when using telemedicine technologies between a provider in one location and a patient in another location may be appropriate and eligible for reimbursement by Blue Cross NC. Services that may be eligible for coverage include:
- Psychiatric services
- Health behavior assessments
- Diabetic counseling
- In-patient and outpatient counseling
- Online evaluations for common health concerns
- Consultations with new and existing patients
- Provider-to-provider consultation
Providers already offering telehealth services to their patients or considering telehealth as an option for providing patient care should review Blue Cross NC’s online Telehealth Corporate Reimbursement Policy. To learn more about telehealth, as well as a North Carolina-based option for helping to introduce telemedicine within your health care organization, the following resources are available:
- Read about telemedicine, what it is, the challenges, and opportunities on Blue Cross NC’s social media blog at The Big Telemedicine Trend: More Coverage, New Innovations in NC.
- Review a recently featured Durham Magazine article, Stay Healthy and Out of the Doctor’s Office, which focuses on TouchCare, a Durham-based company that offers an app for video consults. Blue Cross NC members can download the TouchCare app for free and ask their physicians to join.
- Learn more about telehealth technology and the benefits TouchCare can offer providers’ practices and patients by visiting the your practice page on the TouchCare website.
- Visit the American Telemedicine Association website.
For specific information about Blue Cross NC’s new Telehealth Corporate Reimbursement Policy and how TouchCare can be used to provide patient care to Blue Cross NC members, please refer to these FAQs. You can also contact your Blue Cross NC Strategic Provider Relationships consultant directly, or call us at 1-800-777-1643 for assistance.
2Members must be eligible under a Blue Cross NC commercially insured product or administrative services only included policy. Blue Cross NC’s Telehealth Corporate Reimbursement Policy applies to Blue Cross NC’s commercial product lines only, and does not apply to the Medicare Advantage products offered by Blue Cross NC.