Telemedicine 2016

Your Benefits Now Include Telemedicine What is Telemedicine? A “virtual” doctor visit The next phase of health care Quality care Convenient care Cost effective care Growing trend for millennials 67% of Telemedicine users are ages 21 – 50 65% of Americans have a smart phone A Virtual doctor visit is when medical information is exchanged via electronic communications (video/computer/telephone) for the practice of clinical medicine.

What Channel of Care is Appropriate What Channel of Care is Appropriate? Your PCP should be your first option, but if your PCP is unavailable, try: PCP TELEMEDICINE SERVICE Doctor staffed 24/7 Limited services Minor illnesses (cold, flu, sinus infection, UTI, sore throat, pink eye, headache) Online registration No appointment EMERGENCY ROOM Doctor & specialist staffed 24/7 Provides highest level of care & services No appointment needed Go immediately for stroke, chest pain, heart attack, severe bleeding, major trauma, loss of consciousness, blurred vision RETAIL CLINICS Nurse consult w/prescription privileges Expanded hours, within pharmacy locations Minor illnesses (colds, flu, ear infections, vaccines, strep) URGENT CARE CENTERS Doctor staffed Expanded hours Provides moderate level of care Increased services (stitches, fractures, sprains, IVs, X-rays) Availability When should Telemedicine be used? When your primary care provider is not available While traveling domestically When leaving the house or work is not an option Convenience Increased Risk Non-Urgent Emergent

Telemedicine ― Expands Your Network More options for your employees Increased member satisfaction More providers More services More markets Added convenience Increases member satisfaction by providing members with the care they need, when they need it. Reduces medical cost by providing members with a less expensive alternative for care More options

Telemedicine: Makes Health Care Easier 24/7/365 No waiting for an acute care appointment CONVENIENCE Less expensive alternative for care Saves time No need to miss work for an appointment Telemedicine is another option to meet your health care needs MORE OPTIONS COST- EFFECTIVE Another Way to Provide Healthcare Quality health care for: Common illnesses Flu Cough, Cold, Sore throats UTI Poison ivy Pinkeye Behavioral health Scheduled visits Dermatology Employees are more productive No need to miss work for an appointment Highmark insurance covers: Acute care for minor illnesses falls under the Telemedicine Service benefit Behavioral Health falls under the Outpatient Mental Health benefit Dermatology under specialist office visit Board-certified doctors Secure access via Computer Tablet Smart phone QUALITY HEALTH CARE ACCESSIBLE

Types of Telemedicine Vendor Solutions Local Providers Companies that provide telemedicine services Secure platform Provide national directory of board-certified doctors Claims do not process via BlueCard®; submitted directly to Home plan Local Providers Virtual PCP or retail clinic visit Your doctor may elect to practice medicine via telemedicine Must acquire the necessary technology Specialist Virtual Visit Office visit for follow-up care only Performed by a specialist via a secure video platform Two medical sites are involved: Originating site (where the patient goes to have the service) Distant site (where the specialist is located) Specialist Virtual Visits for specialists with telemedicine capabilities Two member fees may be involved, both process as a SPC office visit SPC at the distant site will bill the copay, if applicable Medical provider at the originating site will bill for an originating site fee, which is subject to plan deductible & coinsurance Virtual Behavioral Health for behavioral health providers with telemedicine capabilities Performed by mental health providers over a secure video platform Outpatient mental healthcare Virtual PCP visit for PCPs with telemedicine capabilities Acute care performed by PCPs over a secure video platform Bills as a PCP office visit Virtual Retail Clinic visit for retail clinics with telemedicine capabilities Acute care performed over a secure video platform

How It Works 2 30 Vendor Solution TELEMEDICINE SERVICE BENEFIT Acute Care* My head is pounding, I can’t stop coughing & my stomach hurts … Local Provider Solution a.m. VIRTUAL PCP VISIT MAY 2 JULY 30 For your next appointment, I’d like to do a virtual visit as I just want to see how those prescriptions are working out for you. Your prescription seems to be working. I would like you to get your cholesterol re-checked.

Telemedicine Options ― Vendors Type of Care Primary Care Behavioral Health Available States 46 states & DC Not available in Alabama, Alaska, Arkansas & Louisiana Not available in Alabama, Alaska, Arkansas & Texas Capabilities Video consult only Video & phone consults Accessing a Provider Acute Care for Minor Illnesses: On-demand appointments 2-minute average wait time Behavioral Health: Scheduled appointments Scheduled video appointments Provider Selection Doctor is assigned Patient may select doctor Website doctorondemand.com amwell.com

Telemedicine Options ― Local Providers Did you also know that Teledermatology is covered under your Specialist Office Visit benefit? Platform Type of Care Dermatology Available States 23 states Capabilities Submit dermatological-related issue along with digital photos via website Accessing a Provider Submit your request and doctor responds within 3 days Provider Selection Patient may select doctor Website dermatologistoncall.com Your PCP, specialist, retail clinic or mental health provider may also have secure video virtual visits available to you.

It’s as Easy as 1-2-3 Request a consult via web or app Select a doctor amwell.com doctorondemand.com dermatologistoncall.com Register/create a profile Medical history Medications Allergies Select your location Doctors will be licensed in the state in which the patient is located Symptoms Select a doctor For DermatologistOnCall, a doctor will reply within 72 hours See the doctor