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Telehealth Expands in PA—Independence Blue Cross Announces Coverage for Telemedicine

On March 14, 2016, Independence Blue Cross (Independence) announced that it is now offering coverage for telemedicine. The coverage option will allow patients to contact a doctor for medical issues that are not emergencies, using HIPAA-compliant video on their smartphone or other digital device.

Independence’s telemedicine coverage offers members two options:

  1. Telemedicine consultation with their local primary care physician (PCP) if the physician offers telemedicine consultations—Available to members who are enrolled in commercial fully-insured and self-funded Keystone Health Plan East HMO or Personal Choice® PPO plans and whose PCP offers telemedicine consultations.
  2. 24/7 access to a nationwide network of board-certified PCPs through a national telemedicine vendor called MDLIVE®—Physicians who participate in MDLIVE can diagnose medical conditions, provide short-term treatment plans, and prescribe necessary medications for non-emergency medical conditions. This option is available to Independence members in select employer groups.

What Physicians and Practices Need to Know about Independence’s Telemedicine Coverage

The Pennsylvania Medical Society’s Practice Support Team reached out to Independence for additional clarification regarding the new telemedicine coverage option. Here’s what we learned:

  1. How many physicians does Independence expect to utilize this service?
  1. Independence’s telemedicine coverage has only been available since Jan. 1, 2016, so it is still too early to have confirmed data on the number of local PCPs participating in the service. However, Independence does expect that the number of local PCPs utilizing this service will increase as awareness of the service grows.
  1. Is there a limit to the number of telemedicine visits Independence will cover?
  1. At the present time, there are no limitations.
  1. Is this service limited to Primary Care Physicians (PCPs)?
  1. At this time, it is limited to PCPs. However, in the future, Independence will be considering other providers.

    Physicians and health care providers can access Independence’s telemedicine policy, including CPT codes, here.

PAMED Resources

Learn more about PAMED’s advocacy and initiatives regarding telemedicine, as well as proposed federal legislation in the form of the CONNECT for Health Act. PAMED members with questions on telemedicine coverage or other Practice Support issues can also call our Knowledge Center at 855-PAMED4U (855-726-3348).

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