Dear Fellow Share Holders and CallingDr Followers,
Over the course of last few days, we have received some excellent questions through our website, which I wanted to share with you. As telemedicine adoption is at its infancy in the healthcare sector (about 1-2%), and it is wide open for a company like us to grab the market share, and help patients access to doctors, we are very excited with the responses from all of you to help us get there. We truly appreciate the confidence you all have shown in the team.
Here are the questions, and our responses:
(1) Since this is completely app based and through smart phone I wonder if Insurance companies will consider this true telemedicine?
CallingDr Platform is not only smart phone base (IOS and Android) but has a WebRTC version also which can be accessed from any browser using any computer.
CMS (Centers for Medicare & Medicaid Services) defines telehealth or telemedicine as “As a condition of payment, you must use an interactive audio and video telecommunications system that permits real-time communication between you, at the distant site (Doctor)”
That definition of telemedicine doesn’t limit usage of technology on any device or form.
So, the simple answer is yes, insurance companies consider this true form of telemedicine platform, as our app confirms to not only HIPAAand HITECH standards, but to also ONC (Healthcare.gov) and CMS guidelines.
(2) How will the examination be done as the patient is not at the clinic?
There are two models a telemedicine can work for a practice:
(a). Physician is remote, and patient is in the Physician office
In this case a nurse can conduct physical exam as per CMS guidelines. This is ideal in case one physician is monitoring or covering multiple sites, or when he needs to travel between offices.
(b). Patient is remote, such as at his home or office
This model of telemedicine is used for follow-up care, medication management, chronic disease management, Medicare chronic care management (CCM), acute cases such as treatment of Flu, Cold, Allergy, minor urgent care, smoking cessation, behavioral health and psychiatric consults, pediatric visits etc.
Telemedicine is not a substitute of doctor visit but according to studies about 45% of doctor office visits can be dealt using telemedicine.
Integrated devices such as smart vital monitors for blood pressure etc. being used for exams (though limited vitals can be obtained today), but integrations are increasing with telemedicine software. We have integrated with these medical device monitors, so we should be able to pick the readings directly from those devices using Bluetooth technology.
(3) How receptive can the doctors be as it will increase liability if they use CallingDr?
Telemedicine adoption is on the rise because more and more insurances have started paying for these services. Patients are also finding it convenient so self-paying encounters are increasing to avoid urgent care/ER visits for acute problems.
Physician’s existing Malpractice Insurance covers telemedicine and additionally Telemedicine malpractice insurances are available to doctors to cover them for liability if they decide to do so with low cost options available and endorsed by ATA (American Telemedicine Association).
(4) Is there some cost to the clinic to participate?
Currently with CallingDr® platform our cost model is simple flat fee model. We have a subscription model based on per provider. We charge a flat fee of $149.95/provider/month for unlimited use of telemedicine technology using our platform to see unlimited patients. Foe example, if a practice has three providers, they will pay~ $450/month. This subscription flat fee model is really appealing to practices as they know they don’t have to pay any extra costs like connectivity, usage or time spent using this platform. Plus we do not charge anything from the patients.
When we release CallingDr on Demand® and FindingDr® platforms later this month, as per our roadmap and connect the patients to doctors and doctors to list their services via our portal, then we can charge physicians listing fees and connection fees with patients. Doctors will only pay a small amount compared to the budgets they have allocated for marketing etc.
(5) Would the doctors be billed per case?
Doctors only pay one-time monthly subscription fee as described above. But since our company is a technology company, we can leverage our resources to offer them in areas where they need help. This can be integration with their EMR systems, helping them secure networks via HIPAA compliance standards, helping them white label our app, if they prefer to. White labelling is important aspect for larger practices and even hospital and care centers, who want to put their logos on the app and customize it to their needs. In addition to this we can advertise and put their name out on FindingDr platform as well as help them integrate telemedicine on their websites. These platforms will link doctors and patients with a way which does not exist now, making it extremely easy for both to connect and interact. There are some vendors out there who offer bits and pieces of what we envision to offer but do not have the complete platform or are not a tech company like us.
(6) Why is the billing not being done by the provider and why is only a super-bill being provided?
With our app (platform), we are giving the provider to collect a co-pay or cash pay payments using credit cards (it is integrated in our system). In addition to co-pay, providers will be billing patients using their insurances, for that we would generate a Super-bill directly from the app/platform, for their billing staff to process the claims. Doctor’s staff will still do billing as they do for in-office visits. This feature gives convenience to Doctor’s who have EMR platforms that are independent of telemedicine platforms. We have integrated with number of EMR (Electronic Medical Record Software) companies and continue to integrate our telemedicine platform with more systems, and will be able to pass the super-bills directly to the EMRs they are using.
(7) Is the CallingDr servicing the patient or servicing the providers?
We are helping both patients and service providers. But charging the providers as a benefit to increase their revenues and reach out to larger patient population. Helping patients find doctors to avoid ER visits, and cut costs.
The main idea behind telemedicine is:
Accessible Patient Care with Convenience
- According to a Cisco global survey 74% of patients prefer easy access to healthcare services over in-person interactions with providers. Adding telehealth to the practice offers patients simple, on-demand care – without the usual wasted time and in office visits. Patients who live in remote locations, or who are homebound or just can’t take off time from work, can access care virtually. Video conferencing, smartphone apps, and online management systems connect more patients with providers than ever before.
Healthcare Cost Savings
- Remote analysis and monitoring services and electronic data storage via telemedicine significantly reduce healthcare service costs, saving money for providers, your patients, and insurance companies. Telemedicine also reduces unnecessary non-urgent ER visits and eliminates transportation expenses for regular checkups. Based on the cost savings, 48 States now reimburse providers equal amounts on the Medicaid Program, in addition to Medicare, which has increased the telemedicine reimbursements for rural areas, and all the big private insurance companies are reimbursing for telemedicine in equal terms under Parity laws in most states.
- Recently, the American Hospital Association reportedon a telemedicine program that saved 11% in costs and more than tripled ROI for investors.
Extended Specialist and Referring Physician Access
- With telehealth, patients in rural or remote areas benefit from quicker and more convenient specialist access. In the U.S., for every100,000 rural patients, there are only 43 specialists available. These patients endure longer appointment commutes and have trouble accessing lifesaving consultations for specific diseases or chronic care plans.
- Telemedicine offers better access to more specialists. Providers can refer their patients to the specific physicians they need, regardless of location. Or, if a specialist is looking to expand your patient population, telemedicine can help you reach a wider geographic region.
Increased Patient Engagement with better patient care
- Engaging patients through telemedicine can help them maintain appointments and care schedules. A new study shows that telemedicine patients score lower for depression, anxiety, and stress, and have 38% fewer hospital admissions.
Increase Practice Revenue decreasing No-shows and Appointment Cancellations
- In addition to these general cost-savings, telehealth can help boost doctors’ revenue by turning on-call hours into billable time, attracting new patients, reducing no-shows, and even reducing overhead for physicians who decide to switch to a flexible work-from-home model for part of the week. According to recent study the overhead cost to see a patient in practice stands at 44%, so doing a tele-visit for a patient who has undergone a procedure adds considerably to the practice overhead savings. Each practice encounters about 25-35% in no-shows (revenue loss) and last-minute appointment cancellations which can be reduced by offering a tele visit consult.
(8) Is there a data sharing agreement with the patients?
Yes, when the patient downloads and installs the app, the first time he/she uses our app or web software, we ask them to sign and acknowledge consent forms based on HIPAA guidelines. If the patient does not consent to the form, they will not be able to use this technology, as per HIPAA rules. This is the same as when a patient visits the practice in-person, he/she signs some forms at the clinic that are designed to protect his rights.
Once again, appreciate all the questions.