THE BEST NEWS I'VE HAD IN WEEKS!
I am delighted to share with you that Regence Insurance, on its own volition, has agreed to provide Telemedicine Parity for its subscribers during the COVID-19 crisis. This is HUGE and I hope other private insurers will follow their example.
While Governor Inslee signed SB 5385 for telemedicine parity yesterday, that won’t be instituted until January 2021. We are proud of Regence Insurance who listened when we asked them to take the action NOW. Kudos to Regence Insurance!
Regence Insurance understands the need to provide healthcare remotely as a form of triage in order to keep patients and healthcare providers safe during the COVID-19 crisis.
Dr. Drew Oliveira worked tirelessly to make this happen and has provided a great summary (below). I believe that this is a first for private insurers in the nation.
Thank you Regence Insurance!
Nancy L. Belcher, Ph.D., MPA
CEO, King County Medical Society
FROM REGENCE INSURANCE:
- Given the extraordinary challenges our medical community is facing, we are expanding the ability for our providers to provide telemedicine services when appropriate for their patients at the same reimbursement as if in the office.
This temporary expansion is for both medical and behavioral health telehealth services to our Individual, group (including administrative services only groups who have the telehealth benefit), and Medicare members. This expansion will remain in effect through each state’s emergency declaration.
Details are on our provider webpage and highlighted below:
•We are expanding the services that can be offered by in-network providers via telehealth.
•The visits are considered the same as in-person visits and are paid consistently with in-person visits.
•The member’s coinsurance and deductible will apply to these services.
•We are following the U.S. Department of Health and Human Services’ (HHS’) lead on discretion with respect to HIPAA compliant platform requirements.
The services must:
◦Be safely and effectively delivered via telehealth
◦Meet the code definition that is billed when provided via telehealth
◦Meet existing coverage criteria, including pre-authorization requirements and medical necessity
•Under this expansion for claims to process correctly, claims must be submitted with POS 11 or IOP and the GT modifier. (Note: To receive reimbursement consistent with an in-office visit, the POS must be either 11 or IOP. The GT modifier will indicate that the services were rendered via telehealth.)
•Claims can be submitted on or after Tuesday, March 24, 2020, for dates of service beginning on March 19, 2020.
Additionally, we will continue to cover the medical and behavioral health codes, as outlined in our Virtual Care (Administrative #132) reimbursement policy. Claims submitted following the guidelines in this policy will be paid as they have been.
Thank you all for the amazing work you do every day.
Drew Oliveira, MD, MHA
Senior Executive Medical Director, Regence Blue Shield