21-680m Report Telehealth Information to Improve Access to Care
Date: 10/08/21
This information applies to Physicians, Participating Physician Groups (PPGs), and Ancillary providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.
Use telehealth services to connect and care for your patients.
Effective October 1, 2021, Health Net, on behalf of CalViva Health, will require providers to report if the option for audio/visual telehealth offered to a member is a Health Insurance Portability and Accountability Act (HIPAA)-compliant technology. This data will be displayed in the provider directories available to members to help improve members’ access to care. The data will also be included in reports sent to state regulators.
Report Telehealth Services
You must report telehealth services by indicating:
- YES (Telehealth and in-person is offered),
- YES (Telehealth only is offered) or
- NO (Telehealth is not offered)
This reporting is required when you submit:
- New practitioner applications or profiles. Telehealth services can be provided in a Telehealth section, notes or in the comment field of the profile. You can also include this in the email notice.
- Updates for existing practitioners. Telehealth services can be provided on the Active Physicians Listing Report (roster) in the “Transaction Type” column A of the roster or in the email notice.
You must also ensure:
- You are compliant with the HIPAA risk assessment for telehealth related platforms and activities.
- Patients are provided options to access health care through face-to-face or telehealth visits and you have the following:
- A verbal or written consent prior to telehealth visits is obtained.
- Documentation in the member’s medical record of the choice for telehealth along with the benefits, risks, and options for the patient.
What is telehealth?
Telehealth is a two-way interaction between you and your patients through telecommunication devices. It is a different approach to in-person visits for qualified providers to deliver care and services to patients.
Telehealth can be conducted with the following types of care:
Type | Descriptions |
|---|---|
Synchronous | These visits are “real-time” face-to-face, audio-visual contacts between the doctor and patient to communicate through teleconferences, webcams, smartphones, tablets or audio-only that does not include the video interaction portion. Example: A doctor having a video conference on Zoom with a patient to talk to them about their diabetes and discuss their blood sugar levels. |
Asynchronous | These visits are not “real-time”, and you are exchanging information without video or audio to diagnose, treat, assess, or consult with your patients on their health. Example: A doctor or clinician uses secure email, text messaging, or an online patient portal (e-visit) to communicate with their patient on existing symptoms. |
Additional Information
Providers are encouraged to access the provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.