Tele-Psychiatry In Oneida

Steps to Implementation Analysis to determine if this approach would be accepted by your Tribal community Access to care was a major issue and determining factor Analysis of vendors available to provide the service We utilized ReGroup because they had the technology readily available and the types of providers we needed Impact to existing Licensure to provide the service Our existing State License DHS 35 as an Outpatient Mental Health Facility had to be modified to approve our facility to provide the services via Tele-Psychiatry This process took us 9 months

On-site Preparation for State Licensure All of our Policies for Tele-Health had to be completed Securing technology within our infrastructure Developing a back-up plan if technology failed Employee Orientation Plan

Tele-Health Orientation Historical Uses of Telehealth History of Telehealth Clinical Application in Telehealth Telecommunications Technology Technology Codes Cameras Consumer Peripherals Transmission Equipment Audio Equipment Presenting Techniques

Tele-Health Orientation Clinical Services Safety and security during the service provision Privacy and Confidentiality Documentation Consumer Rights Back up Procedures Patient Preparation for Tele-health Market the Program to the Community!!

Tele-Psychiatry Scheduling and Billing for Services Define Appointment Types BH-TEL Medication Check Follow-up BH-TEL RX refill BH-TEL Adult Eval BH-TEL Medication Check Billing for Telepsychiatry (Medicaid Update No. 2004-88) The service is a service that is covered under one of the Medicaid mental health or substance abuse benefits: Outpatient Mental Health Outpatient Substance Abuse Pharmacologic Management Mental Health Substance Abuse Day treatment Crisis Intervention Community Support Program Comprehensive Community Services Child/Adolescent Day treatment services

Barriers We Experienced Internal system security for the Doctor to be able to work remotely with all of our systems. System speed SLOWNESS! Time Delay for Credentialing of the Provider for WI Department of Safety and Professional Services (DSPS) 3-6 months for final approval Provider needed to be licensed in the State they are providing services Getting Staff on Board Some were hesitant about using the technology Change!

Procedure Codes The Provider indicates the “GT” Modifier on the claim detail for the specific procedure code “GT” Modifier is defined: Via interactive audio and video telecommunication systems This table shows the services for which tele-health and the “GT” modifier are allowed and are not allowed Service Procedure Code Telehealth Services Covered? Outpatient Mental Health and Substance Abuse 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90814, 90815, 90816, 90817, 90818, 90819, 90821, 90822, 90823, 90824, 90826, 90827, 90828, 90829, 90845, 90846, 90847, 90849, 90862, 90875, 90876, 90887, H0022, H0046, H0047, T1006   Yes 90853, 90857, 90865, 90870, 90871, 90880, 90899, H0005 NO