Doctor Visits by Phone: A New Way of Health Delivery in Alabama

Dr. Darrell Weaver, BlueCross BlueShield of Alabama vice president of Healthcare Networks Services

In the last six weeks of the virus crisis 270,000 doctor visits have been conducted successfully over cell phones.

It’s an innovation in health care delivery in Alabama that’s likely to become a permanent improvement in how health care is delivered.

Rather than taking off from work and sitting in a doctor’s waiting room, patients can consult effectively with their doctor over their cell phones, using video, and get what they need without the traditional waits and check-ins at the reception desk.

And have the treatments fully covered by their insurance.

The later is owing to a rapid change in policy deployed by BlueCross BlueShield of Alabama early in the state’s encounter with the virus outbreak.

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On March 12, BCBSA announced its decision to cover in full and without co-payments all telephonic treatments by its network of over 10,000 physicians. And it has gone without a hitch.

“It was very easy for us to do. We told every one of our physicians in the state, 10,000, including behavioral health providers, that we were opening it up and they can do it now,” says Dr. Darrell Weaver, BCBSA vice president of Healthcare Networks Services.

“It was something that could be done very quickly, telephonic care, and we said,  ‘You can do it to certain levels of care. There are levels of care from 1 to 5 established by the AMA, and when we started we said we would cap it at level 3 and see how it went. Since then we have included up through level 4,” says Weaver.

Weaver notes that telehealth is separate from telemedicine, a category of care that requires special equipment, such as video technology that can exchange X-rays.

“We’ve been rolling out other specializations that have been covered, such as physical therapy and occupational therapy. These did require a video component, but an iPhone can work. Say you’re delivering physical surgery. The doctor can ask a patient recovering from knee surgery to show me how much you can bend your knee. ‘Keep bending it,’ he says. He observes. Likewise with speech and occupational therapy. If a child has learning or developmental disabilities, in a video the provider can talk with the child: ‘There’s a coloring book in front of you. There are three objects. Draw a circle around the rabbit.’ There are ways do a fair amount of care.”

Nor has the paperwork been a problem, says Weaver. No need for special software of medical practice management systems.

“It didn’t require specialized equipment or fancy billing. Billing is done the same as you do in the place of service, whether an emergency room or a doctor’s office.”

Doctors were more than happy with the change, especially under the circumstances, says Weaver.

“People were staying away from doctor’s offices, as they should. And this was a way for providers to put money back into their pockets,” says Weaver.

Weaver says BCBSA has covered at least 270,000 telephonic office treatments since mid-March.

To make sure that there were no hitches because of doctors having to check co-payment requirements, BCBSA dispensed with copayments during the changeover.

“We didn’t want to throw copayments into it when physicians might be working from home with no way to check,” Weaver says.

Will BCBS continue with its telephonic coverage when the virus crisis ends?

“I really hope so,” says Weaver. “When we started, we said it was temporary, but what we’ve done has been so effective, we said we’d continue it until June 1, with the option of continuing beyond that. And it seems to be working well so far, so we hope to continue after June 1st indefinitely.”

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