IHI COVID-19 Crowdsourcing_3.18

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1		IHI COVID-19 Crowdsourcing	We encourage you to leave your name and organization to better facilitate sharing and learning from one another. Have a document you'd like to share? Email it to IHIAllianceTeam@ihi.org and the IHI team will upload to Google Drive and link it to your submission.
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5	What is your most tangible piece of advice for health care organizations seeking to rapidly scale their telehealth efforts?	Helpful Links and Resources	(Optional) Name and Organization
6	Be flexable, While going for the ideal do not
7	prohibit something just because it cannot be
8	billled. Think outside the box but not too far outside
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10	Drive by testing, receive stick on test tag for license plate. Only vehicles with test certificate decal allow on roads within designated states
11	Ensure that providers are reimbursed at the same rate for telehealth that they are for in person visits - I ran into this on Tuesday & placed a call to the Attorney General's office - Tufts reimburses providers 80% of what they would for in person visits - my provider worked with me to keep the visit, but others may choose to skip the appointment
12	Note that billing authority varies by line of business: Medicare (FFS and MA) plans are regulated by CMS, Medicaid (FFS and MMC) and commercial fully-insured plans are regulated by the state, and commercial self-insured ("ASO") plans are largely at the discretion of each employer		Trevor Brandt-Sarif, Mount Sinai Health System
13	Right now (in the time of COVID response), at least for NY State, all state-regulated plans (commercial fully-insured and Medicaid) must waive all cost-sharing for all telehealth services (not just COVID-related); however, as of 3/19, Medicare plans were still seeing normal cost-sharing	http://view.gnyha.media/?qs=f387106f0c2a3e1cbb5af8326458ac994a53c6cc017a7124edce103c3710c63c430264bf55309caa870fd8dae21d5daa28b71a6fe365af4cc425706a7e925499a0542ee5e74c630d	Trevor Brandt-Sarif, Mount Sinai Health System
14	NY State (as do some others) has a telehealth parity law (since 2016)--all CPT codes covered for in-person care must be covered when delivered by telehealth (by state-regulated plans), so long as delivering that care by telehealth is clinically appropriate (if not in NY State, check if your state has a parity law as well; many do)	To check if your state has a parity law, check: https://www.cchpca.org/telehealth-policy/current-state-laws-and-reimbursement-policies?jurisdiction=All&category=All&topic=11	Trevor Brandt-Sarif, Mount Sinai Health System
15	For billing, maybe sure to add Place of Service Code '02' on claims sent out to payers for any telehealth services		Trevor Brandt-Sarif, Mount Sinai Health System
16	Check out Center for Connected Health Policy, great resource to figure out what all your state regulations are	https://www.cchpca.org/telehealth-policy/current-state-laws-and-reimbursement-policies?jurisdiction=All&category=All&topic=All	Trevor Brandt-Sarif, Mount Sinai Health System
17	Technical support is critical. Organizations can leverage those individuals who have been in improvement collaboratives who can provide expert guidance on technology-Zoom sessions-just the fundamentals and tech support that does not require tech personnel-use those who have been high users.
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19	We are in the most extreme case. Did not have a telehealth system in place and now having to get the whole thing up and running in days. We are using a combination of systems to get the system online as quickly as possible. Some providers are using Skype and logging into our EMR remotely, some are in the clinics and using doxy.me for telehealth. The most important thing is that we stay flexible and meet the patient where THEY are. We are asking providers to adjust to the patient's needs. Have providers download 2-3 systems in advance and that way they can quickly log in to the one that the patient is most comfortable with and able to operate quickly.		Danielle Farnan, University of Toledo Physicians, LLC (UTMC)
20	We decided the departments to bring online in order of demand due to the emergency. We get Psych up first so that they can provider counseling services to patients while we can get the ambulatory providers up and running. Elective services will be last.		Danielle Farnan, University of Toledo Physicians, LLC (UTMC)
21	This is also a great site for resources in the Midwest	https://www.umtrc.org/resources/	Danielle Farnan, University of Toledo Physicians, LLC (UTMC)
22	I also added two tabs to this worksheet for "Cheat sheets" that we created for our organization. Just to help share and consolidate information for Telehealth and COVID billing. Not sure if others might find them useful.		Danielle Farnan, University of Toledo Physicians, LLC (UTMC)
23	Have a plan in place for instances when calls or video communication fails or is delayed - latency delays can and do happen and can add to the stress of providers. Get back up numbers/have a back up mode (e.g., strategy for moving from video to audio when starting the call so people can reconnect quickly.		Alexis Battista, Uniformed Services University of the Health Sciences
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