All SJIPA Members/Billing Managers: Telemedicine
San Juan IPA has received a few calls regarding which Payers covers telemedicine in relations to COVID-19. See below insurances.
- Aetna – Covers Telemedicine
- BCBS – Covers Telemedicine
- Molina – See attachment
- True Health NM (THNM) – Cover telehealth services using a HIPAA compliant platform. Please advise practices to submit billing with the appropriate place of service and code. No modifiers or prior authorization are required.
- United Healthcare – See attachment
- Western Sky – (Waiting on Wester Sky to respond to NM Medical Board letter) https://www.westernskycommunitycare.com/content/dam/centene/newmexico/Medicaid/PDFs/Telemedicine_Guide_F.pdf
- Presbyterian – (Waiting on Presbyterian response on letter from NM Medical Board for providing care by electronic means during a crisis. In the meantime, below is Presbyterian’s requirements for telemedicine. We will update once Presbyterian responds).
- A Letter of Interest (LOI) must be submitted to SJIPA to add this service to your contract. Below questionnaire is what is reviewed when approved for this service.
- Obtain member written consent specific to participation in telehealth
- Have written protocols to ensure telehealth services meet the requirements of state and federal laws and established patient care standards
- Have written protocols for management of urgent/emergent situations
- Maintain a complete medical record of all telehealth services provided to members
- Provide all telehealth sessions through secure and HIPAA compliant technology
- Practice must be covered by professional liability insurance for required limits per occurrence and aggregate through self, group or employer and include services performed via telehealth in the coverage territory where the provision of services occurs
- Please identify what secure technology you currently use
- Group & Pension for Jaynes Co. – Not covered
- Summit Administration/NAS – (NAS will let SJIPA know if this will open to all providers)
- NAS schools offer telemedicine only through Teladoc. This may be something that will be reevaluated in another couple weeks.
As additional information is received from various insurances and resources, we will send on an Alert email.
For a webinar on telemedicine please see link for upcoming webinar schedule on March 18, 2020 hosted by National Consortium of Telehealth Resource Centers. https://www.telehealthresourcecenter.org
Medicare Administrative Contractor (MAC) COVID-19 Test Pricing March, 2020- See attachment
All SJIPA Members and Office Staff: NM Medical Board- Guidance for Providing Patient Care by Electronic Means During a Crisis
