Telemedicine From the Malpractice Perspective


Hello everybody. Eric Hoffman here back again with your five minute crisis response for chiropractors. Today what we’re going to review is how to work with telemedicine in the age of COVID-19. A common question we’ve been getting over the last couple of weeks as doctor’s offices are shifting, getting creative and modifying their structure to not only survive, but to thrive is how does telemedicine work? Will we be covered? What are some of these things that we need to be made aware of?

So to address the first part about coverage, because we are at the end of the day, your malpractice insurance provider, so will you be covered? Our stance has not changed whatsoever on telemedicine. We have and will always cover it. And what I mean by that is our policy language dictates that we’ll cover you for things that are within your scope of practice to do in your given state.

That being said, not every state recognizes these things. Not every state has a specific statute or rule or regulation surrounding tele-health. So what does that mean for you and what are these gray areas dictate when we’re talking about coverage? In most cases, the states that have addressed this have indicated that as a chiropractor you are able to perform telehealth services as long as you’ve established a patient doctor relationship in person, first and foremost in the state where you’re licensed.

Secondly, you can practice telehealth after the fact with your existing patients as long as they reside in your state of licensure. That’s the gist of it, and if you follow those rules in most states, you won’t have a problem. There are other states that dictate different things. Some allow you to do it, but only a certain amount of visits. Some states don’t say anything about it and they’re silent on the matter.

In those cases, gray areas tend to be a little bit more flexible for you because they haven’t addressed it yet, and if and when they do address it, that’s when you need to follow those new or modified rules. If they haven’t, you do have certain flexibilities and our coverage doesn’t say if they’re gray, then you won’t be covered. There’s no exclusion for it. So in most cases you still would be unless there’s a precedent set.

So again, we’re advising as much as possible to consult with your state board and or state association to find out what your current rules are today to perform these services. And with the COVID-19 pandemic going on, a lot of the boards are making changes, becoming more flexible and actually finally addressing this issue of telemedicine in its entirety because a lot of doctors are going to them searching for answers.

I know New York has been one of those states that have made certain changes and updates to their rules. Florida has historically made certain changes and allowed a lot of flexibility with telemedicine. There are, I’m sure other states that I may not be aware of. Your state may be one of them. So in terms of coverage, to recap, as long as you are making sure you’re following the rules and regulations of your specific state where you’re licensed, then our coverage will be there for you.

Secondly, if you are a person who wants to see patients perhaps outside of your states, generally speaking, that is not appropriate. You are not licensed in the other states, assumingly, if that’s the case, and therefore you would be practicing there without a license. It’s as if you are putting your hands on somebody in another state that you don’t have a gainful license in and if you can’t do that, you can’t perform the telemedicine services. So, that’s the rule of thumb. Again, we’re in uncharted territories. There’s flexibilities being opened up in certain states. Keep that in mind, but as a rule of thumb, you can only do it in the state where you’re licensed.

Now, outside of that, there are certain guidelines that you need to follow. We aren’t going to go through today anything about the insurance aspect of it, how to bill and code. We as Chiro Secure have done other videos like that and have addressed these in certain respects. In fact, just yesterday we had our friend Mike Misco who is an attorney that deals with a lot of our insurance audits go through a lot of the laws and regulations surrounding telehealth. So I advise looking into that, and more importantly, you’ll see on today’s episode there’s going to be a banner at the bottom for you to text a certain code to receive transcripts.

We’ll also be sending you the informed consent form that has been put together for telemedicine. And also we’ll send you a link to a show that we did with Sam Collins of HJ Ross about the billing and coding of telehealth and telemedicine. So all of these resources hopefully will help you get started if you haven’t already. If you have already, hopefully it’ll help you either modify or dial in your approach so that you can be in the guidelines, be safe, be proactive, and make sure you’re doing things properly.

So for today, that’s going to be it and we appreciate everyone that’s been tuning in, sending in your comments, your questions. We really appreciate it. We want to be here for you, going over these types of things and making sure you are well protected and well taken care of. So thanks again. Please stay safe, stay healthy and we’ll see you soon. Thank you.

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