(Integrating) Telepsychiatry in a Private Practice

[Sushirolls]

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This thread is not meant for picking up telepsychiatry gigs, or working for a telepsychiatry firm, or how to make the dream of living outside of the US viable while doing telepsychiatry.

This thread is meant for existing brick and mortar practices that already are offering telepsychiatry services or considering the addition in the future. What are people using for their interfaces? What are the nuances of insurance reimbursement? What about medicare? Are there specific nuances to charting with the MSE? What are some of the things that are different about telepsych you've learned compared to traditional face-to-face encounters? Any camera or band width or microphone learning experiences?

I've either been told or read somewhere on SDN that doxy.me is a possible platform to use. Any experiences with this company?

 

[TexasPhysician]

Doxy.me has some lag issues at times and requires a good internet connection to work fairly well in my opinion. I don’t love it, but it is free.

That said I haven’t been excited about any face to face software yet, even mainstream FaceTime or Skype.

While I use telepsych in my cash practice, I wouldn’t do it for new patients. The technology isn’t there to make it equal to in-person.

 

[romanticscience]

Facetime (Apple) and Skype (Microsoft) will not sign a BAA. So, although they are likely secured, you're not assured. I started using doxy.me but have become disappointed with the lag/quality.

BCBS will reimburse for these appointments. You just have to use 02 for the place of service and GT modifier codes on the HCFA 1500.

Now, I'm trying out google meet. I subscribe to their g suite which comes with a BAA. More info on google g suite and HIPAA here.

 

[calvnandhobbs68]

We do telepsych (although not in a private practice setting). I typically find it to be lacking compared to an in person interview. Still a decent amount of technical issues (video lag, audio lag, audio not working, etc) which throw off the whole interaction. Also more difficult to get severely mentally ill or generally un-cooperative people to engage well (this would be less of a problem in private practice of course). Patients don't seem as satisfied with it in my experience unless there is truly no other way to see the doctor they want in a timely manner.

I see the value for telepsych for people who otherwise wouldn't be able to see psychiatry at all but I suspect many patients like to see a doctor in person for any actual problems. You might have quite a few takers who just need their SSRI or stimulant refilled every few months after a check in though.

 

[sighchiatry]

I use doxy.me. It's easy to use and works most of the time, but I don't love it either. Lags and is buggy.

Going to check out google meet next.

The patients that are appropriate for telepsychiatry generally love it.