Telehealth Credentialing Challenges

The field of telehealth is growing with regulatory changes paving the way for digital health companies to offer services. Federal and state policies have also helped increase access for more patients, changing how people choose and receive their health care. As this field expands, some physicians may encounter challenges when dealing with provider credentialing, state regulations, informed consent, and payment. With many changes coming down the road, physicians should be informed on how these regulations progress.

Credentialing

Up until recent years, most physicians and clinicians only needed to get credentials for the states that the practiced and lived in. Today, telehealth allows patients to seek care from physicians from all over the country. Since this process is handled by state, doctors may face roadblocks when trying to work out their credentialing.

The Interstate Medical Licensure Compact (IMLC) is an agreement that currently has 29 states participating, including Pennsylvania. It is not a federal government program or agency; it is an independent agreement among sovereign states. Licensed physicians may be eligible to practice medicine in other states if they qualify. The application procedure leverages information already submitted by the physician to their state of principal license, verifies it, and institutes new background checks. If accepted, the doctor can choose any of the states that are part of the IMLC; there are also interstate compacts for other groups of providers, including nurses.

Some state medical boards also allow out-of-state providers to provide telemedicine care in other states if they meet certain conditions. There are additional proposed rules in other states with different guidelines. For now, there are no set regulations that cover everyone.

Consent

Like other patients, those that wish to use telehealth services must give their providers informed consent. When services are provided in person, the patient can sign an agreement. Telemedicine informed consent agreements explain the provider’s services, risks, and benefits associated with treatment, and ensure that a patient completely understands how telehealth works. There are state laws that govern informed consent agreements, although they may also need to change to accommodate today’s digital health platforms.

Reimbursement

Federal and state regulations about provider payment for telehealth services are another gray area. There are 11 states that reimburse physicians for store and forward services, but others do not. Others require that telemedicine be carried out in real-time, involving interactive audio and video, to prevent misunderstandings and preserve patient-doctor relationships.

Medicare and Medicaid both have their own restrictions, such as only paying for telemedicine in more rural settings or requiring services to take place in specific facilities, like hospitals. However, there are signs that they are showing more flexibility, and allow the use of store and forward, as well as other internet-enabled technologies.

Philadelphia Physician Lawyers at Sidney L. Gold & Associates, P.C. Help Medical Professionals with Credentialing Needs

The rapidly evolving field of telehealth is easier to navigate when you have a Philadelphia physician lawyer at Sidney L. Gold & Associates, P.C. on your side. For a free consultation, call us at 215-569-1999 or complete our online form. Located in Philadelphia, we serve clients throughout Wilkes-Barre, Scranton, northeast Philadelphia, Bucks County, Chester County, Delaware County, and Montgomery County