Despite our essential business status, physical distancing strategies decrease demand for chiropractors’ hands-on treatment as people try to stay home more. However, we are able to apply our broad knowledge and skill sets to continue serving the people of NH, even when they aren’t able to reach our offices. Telehealth provides an opportunity to reach people in their homes.
There are a broad array of services available for telehealth consults. To hit the ground running, choose one that is affordable and simple to use for you and patients. Free options include Doxy.me, and other options ranging from Google Meet at $12/mo or VSee at $50/mo, to ExamMed and Zoom for Healthcare at $200/mo. The cloud-based EHR Jane, which is popular among chiropractors, integrated a telehealth feature in March in response to increased demand, and we will see this market continue to grow.
Each of the options listed above is HIPAA compliant. However, the US Department of Health and Human Services announced that during the emergency period they have relaxed HIPAA restrictions around remote consults. They are prioritizing getting care to patients, so they’ll honor our good-faith attempts to provide quality care, even if that means using more informal services like FaceTime, Skype, Messenger or Hangouts. In NH, emergency order #8 also interpreted the use of audio-only phone consults as valid telehealth service.
You should also know about billing and regulations. Medicare only covers manipulation codes, so we are excluded from telehealth reimbursement. NH Medicaid plans mostly exclude service from chiropractors, but plans that allow chiropractic are currently expected reimburse for telehealth under emergency order #8. Private insurance plans are expected to reimburse for telehealth consults and guided rehab at the same rate as in-office care, though this may vary. According to ChiroCode, E/M codes will be used most frequently, with level based on time and coded with a -95 modifier. You should brush up on this documentation and coding at the ChiroCode website. Additionally, VP Pence has also encouraged states to create temporary avenues for interstate telehealth, a situation we will continue to monitor.