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TELEHEALTH

 

Telehealth is providing psychotherapy/counseling over the internet.   It might be only audio, which is more like simple telephone communication.  Or, it might combine with a video feed, like Skype or facetime.   Telehealth is called by many names--videocounseling, telecounseling, etc., but all facilitate connecting with someone via an electronic device vs. person-to-person.

Telehealth sessions have to comply with confidentiality laws, known as HIPAA.   For this reason, non-confidential services such as Skype or facetime are not usually utilized.   I'm trying out VSee, which is a secure and free platform for both the provider and client.   It is simple to use, set up and should work well for both of us.   Here's a link to research VSee and to download/install their software:

  VSee


Telehealth is more and more accepted by insurance companies, so payment is less and less a problem.   There are special codes to use for telehealth sessions, but billing and payments should be the same as face-to-face sessions.   Before setting up a session, check with your insurance carrier to see if this service is covered.   If telehealth is not covered by your insurance carrier, then private billing is OK.   There are many online services that handle payments--echeck, Google Wallett or PayPal.   You can also send check or money orders via snail mail.
    
There are also independent services that provide HIPAA compliant platforms and sometimes do the billing for you (and me).   Some of these are Healthtap, Amwell, MDLive, Teladoc, MyIdealDoc, Breakthrough and Talkspace.   I am a fully matriculated provider on Healthtap, and Teladoc, so check with them to see if they bill insurance companies for you.   So far, the other providers have not been attractive for a number of reasons--patient and provider costs, low reimbursement, high paperwork requirements, etc.   However, if you like a particular one, let me know and I'll see if it will be good for both of us.   I usually use Healthtap because it has a clean, well-organized platform that works, but Teladoc is still an option..  
 

Healthtap
Teladoc


Prior to starting telecounseling, you will need to sign some forms.   The first is the Informed Consent, which outlines the terms of service--where you give me permission to work with you over the media. It also contains contractual information about finances, confidentiality, record keeping and the intent of counseling.   It's the same form I use for face-to-face visits, adapted for telecounseling. Copy, print it, fill it out, and then fax it to me at 760.471.1844.  (Email, texting, screenshots sent via text or email are NOT confidential, so I don't use them.)   Here's the link to the first form.

Informed Consent


The second form is for insurance information.   Copy and print this form, and then call your insurance carrier if you have one and ask them the questions. Write down their answers, exactly, and then, also fax this. I'll do all the paperwork for you, I just need the correct information. In the digital age, if the numbers are off by only one digit, everything fails.  If you don't plan on using insurance, skip this step.


Insurance Information

Telecounseling is not currently suitable for emergency services.   There are days when I am not in the office and don't see clients in real time in the flesh.   The same is true for telecounseling.   Emergencies or after-hours concerns should be directed to either 911, your nearest ER or the San Diego Access and Crisis line (available 7/24/365):


1-888-724-7240

Telehealth is also fully covered under my malpractice insurance, as long as I don't practice across State lines. For this reason, I only work with clients in California. For anyone who's interested, the link to my malpractice insurance is:

American Professional Agency