WRS has expedited the release of new Telehealth functionality to assist providers in conducting remote patient encounters during the COVID-19 Pandemic. We are pleased to offer this functionality to all current clients at no cost until June 30, 2020.

Please complete the Telemedicine Signup Form to enable the functionality below in your practice immediately.

Sign Up for Telehealth Service

Note: In order to use this functionality, your practice must be enrolled in Telehealth functionality. It will be offered free-of-cost until June 30, 2020. Complete the Telehealth Signup Form for setup.

Check Hardware & Software Setup

Be sure to setup the device (PC, MAC, iPad or Cell Phone) that you plan to use for the telehealth visit. All setup requirements and testing suggestions are detailed in the following videos and PDF documents.

It is strongly suggested that a front desk representative is equipped with a noise-cancelling headset with microphone. This allows the front desk user to join the telehealth session in advance of the encounter (30- minutes prior) and privately assist patients with Telehealth setup, Self Check-in and collection of intake data. This should happen 30-minutes before the actual encounter with the provider.

New Telehealth (System Default) Appointment Type

A new Telehealth (System Default) Appointment Type is now available in your practice. You will see this under Administration>Scheduler Setup>Practice Appointment Type.

Schedule a Telehealth Appointment

IMPORTANT NOTE: Success with the Telehealth Workflow requires use of the Telehealth (System Default) Appointment Type. Use of any other appointment type will prevent the complete Telehealth workflow.

All previously created (non-default) custom “Telehealth” appointment types should be renamed to avoid user confusion. All appointments made with these custom types should be adjusted to use the Telehealth (System Default) Appointment Type.

(1) To make a Telehealth Appointment just use your existing Appointment Scheduling workflow.

(2) Simply select “Telehealth” under the dropdown Appointment Type Box.

Review Patient Email & Self-Check-In Workflow

One you have scheduled a patient using the new Telehealth Appointment Type, the patient will receive a Telehealth Appointment Confirmation Email and Appointment Reminder Emails. These emails include links to PDFs and videos that explain the use of the Patient Self Check-In process (desktop and iPad only):

Patient Self Check-In

This emails also contain a link for Patient Self Check-In. Upon clicking the Patient Online Check In Module link, the patient will be asked to enter Last Name and DOB. If they match a patient in today’s schedule, they will be taken to a series of automated Check-In screens. This is called the Patient Check-In Module.

During Self Check-in, patients confirm demographic and contact info, enter a preferred pharmacy, pay a co-pay due and check-in from their desktop PC/Mac. The process includes approximately 6 screens and should take them only a few minutes.

Once the patient has completed Check-In their appointment status in WRS under Todays Appointments will automatically be updated to WRS to Step 2- Check-In.

You can then move them to Step 3 Move to Exam Room and begin the telehealth video portion of the visit by clicking on the telehealth link (below)

Launching a Telehealth Video Session

Once the patient has been Moved to Exam Room in WRS, simply mouse over the patient name and press the Launch Telehealth button on the Patient Information Box. This will take you to the patient’s telehealth video room in your browser window.

Note that each patient will have a different video room. The link will consist of meet.wrshealth.com and a unique set of 6 digits for each patient:

meet.wrshealth.com/a23b5c

Revenue Cycle Management for Telehealth Visits

Due to the Coronavirus (COVID-19) Public Health Emergency, doctors and other health care providers can use telehealth services to treat COVID-19 (and for other medically reasonable purposes) from offices, hospitals, and places of residence (like homes, nursing homes, and assisted living facilities) .

Coinsurance and deductibles apply. For Medicare. Patient Responsibility is 20% of the Medicareapproved amount. Part B deductible applies.

If the patient has coverage through a Medicare Advantage Plan, they will not have to pay out-ofpocket costs (called cost-sharing) for COVID-19 tests.

Medicare telehealth services include office visits, psychotherapy, consultations, and certain other medical or health services that are provided by an eligible provider who isn’t at your location using an interactive 2-way telecommunications system (like real-time audio and video.

Documentation Requirements for Telehealth

• Documentation requirements remain the same as an in-person visit.
• Documentation should include patient’s name and date of birth; provider’s identity and credentials; verbal consent from the patient to receive virtual services (required by CMS); a statement that the service was provided through telehealth; and the locations of the patient and the provider.
• Time-based codes may also have additional requirements to verify the time spent on services. Include the Start time of visit, End time of visit, Total time of visit, and Discussion topic to include the medical necessity (e.g., history, action)

Billing Requirements for Telehealth

Given the variability and frequency of updates in payer policies, we recommend

(1) billing the set of codes that most accurately characterize the services conducted remotely and

(2) applying the appropriate place of service code and (3) modifier.

The billing for a new patient visit should be based on time since there is no exam.

The billing for an established patient visit can be either based on time or the level supported by

History and Medical Decision Making.

Level 2- Problem focused history/Straightforward

Level 3- Expanded problem focused history

Level 4- Detailed history

Level 5- Comprehensive history

For time-based E/M levels, more than 50% of the visit needs to be spent counseling/coordinating care:

The modifier 95 should be added to the codes. Note that the reporting of telemedicine services varies by payer and state regulations. See CY 2020 Medicare Telemedicine Services to view the Covered Telehealth Services CY 2019 and CY 2020.

Place of service code: 02 – Telehealth. This place of code certifies that the services provided met Telehealth requirements.

Modifier: Medicare stopped the use of modifier GT in 2017 when the place of service code 02 (Telehealth) was introduced. If your payers reject a Telehealth claim and the 95 modifier is not appropriate, ask about modifier GT.

• GT modifier: Via Interactive Audio and Video Telecommunications Systems. Check payer policies for specific codes. (See HCPCS Level II Expert® 2020 Edition, p. 473)
• GQ modifier: Via Asynchronous Telecommunications Systems. See payer guidelines for specific codes that require or are eligible for the GQ modifier. (See HCPCS Level II Expert® 2020 Edition, p. 472)
• G0 modifier: Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke. Check with CMS and payers if uncertain that a code qualifies for this modifier. (See HCPCS Level II Expert® 2020 Edition, p. 465)
• 95 modifier: Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system. (See Appendix P in the CPT® 2020 Professional Edition, American Medical Association, p. 896)

On a daily basis, the rules related to Telehealth, and payment for Telehealth are evolving, and misinformation is abundant. We will keep you updated as information becomes available.