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Telehealth for Behavioral Healthcare Credentialing, Screening, and Monitoring Challenges

November 17, 2020

COVID-19 has impacted every aspect of life, and these changes have affected people’s mental health, making telehealth services more important than ever. Decreased physical activity, disruption to exercise routines, increased social isolation, and economic decline all have the potential to adversely affect behavioral health. Unfortunately, some people manage social isolation and pandemic-related stress by increasing adverse health behaviors such as smoking, alcohol, or drug use. Others may become more susceptible to mental health issues such as depression or anxiety.

In light of these changes, a digital health intervention through telehealth has become an increasingly valuable tool for improving access to services and quality of care. While the use of telemedicine in the U.S. was minimal prior to COVID-19, implementation of telemedicine has expanded rapidly as policymakers, insurers, and health systems sought ways to deliver care to patients in their homes. With growing demands for telemedicine, several changes have been made to telehealth policy, including telepsychiatry.

Requirements That Address Credentialing Verification

Telehealth credentialing verification of telehealth providers has changed. In the Comprehensive Accreditation Manual for Behavioral Health Care, the Joint Commission requires credentialing verification of telehealth providers including all who provide care, those who volunteer, and behavioral health profession students. Three important regulations outlined by the Joint Commission address the following:

  1. Telehealth tools must use non-public facing applications as telemedicine communication platforms. Providers are encouraged to notify patients that these third-party applications potentially pose privacy risks and should enable all available encryption and privacy modes when using such applications. Public-facing applications such as Facebook Live and Tik Tok are not allowed for telehealth communications.
    1. Telepsychiatry services which are allowed digital intervention include (but are not limited to) treatment or diagnosis of:
      • COVID-19 related symptoms
      • Mental health counseling for individuals or groups
      • Psychiatric consultations
      • Psychological evaluations
      • Adjustment of prescriptions
      1. Audio-Only Telehealth is allowed for specific services. The Centers for Medicaid and Medicare Services (CMS) has waived video technology for certain services and audio-only telehealth is authorized for services described by the codes for telephone evaluation, management services, and behavioral health counseling and educational services.

      Some of the Top Telehealth Challenges for Behavioral Healthcare

      While telemedicine provides increased access to mental health services, digital visits also present challenges. Organizations should be aware of these challenges in order to mitigate risk in the following areas:

      • Digital security: According to the American Psychological Association, telepsychologists should inform clients/patients of potential risks to confidentiality inherent in the use of telecommunication technologies. The APA also advises that “psychologists obtain the appropriate consultation with technology experts to augment their knowledge of telecommunication technologies in order to apply security measures in their practices that will protect and maintain the confidentiality of data and information related to their clients/patients.”
      • Limited access to technology or outdated technology: Rural areas with limited access or outdated technology may reduce video or audio quality or prevent patients from accessing services entirely.
      • Reimbursements with no federal statutes: Parity (equality or uniformity) is a significant issue as telepsychiatry is implemented. Currently, no federal statute requires payers to reimburse telemedicine encounters at the same rate as in-person services or even secures payment at all. Currently, only 10 states have true payment parity laws for reimbursement rates for in-person and telehealth visits. Those states are Arkansas, Delaware, Georgia, Hawaii, Kentucky, Minnesota, Missouri, New Mexico, Utah, and Virginia.

      Telepsychiatry Best Practices 

      To help address challenges and provide safe, effective services, the American Psychological Association and the American Psychiatric Association have issued best practice guidelines for telepsychiatry. These guidelines span from privacy and security to infrastructure to accessibility. Some guidelines for best practices in telepsychiatry include (but are not limited to) clinical, administrative, and technical dimensions.

      These guidelines include (but are not limited to):

      • Regarding digital security, psychologists should discuss clients’ role in ensuring privacy and security within their environments since the psychologist cannot control those factors remotely.
      • The APA advises that clients/patients may have varying degrees of technological skills or ability to thoroughly read and understand informed consent and billing. Due to limited access or outdated technology, verbal explanations and consent may be necessary to augment written consent and billing. Verbal discussions around fee structure may “also include discussion about the charges incurred for any service interruptions or failures encountered, responsibility for overage charges on data plans, fee reductions for technology failures, and any other costs associated with the telemedicine services that will be provided.”
      • Interjurisdictional practice has become more accessible in telemedicine. Due to the current public health emergency, HHS waived requirements for physicians or other health care professionals to hold licenses in the state in which they provide telemedicine services with respect to Medicare and Medicaid services. Similarly, psychological services systems have been established such as the U.S. Department of Defense and the Department of Veterans Affairs. However, while laws and regulations around credentialing and licenses in telemedicine are being streamlined, healthcare organizations should be aware that laws and regulations outside of those systems vary by state.

      A New Normal: Telepsychiatry for Behavior Healthcare

      With increased accessibility to high-quality technology and the growing demand for telemedicine during the global pandemic, telepsychiatry is likely to expand exponentially. While there are still some concerns regarding the use of technology platforms and security, third party security services are also expanding to meet the growing demand.

      Verisys provides the leading provider database technology for medical credentialing. By adding automated, real-time provider screening with FACIS, your healthcare organization can automate medical credentialing for telehealth services no matter where your physicians or staff practice.

      Healthcare administrators agree that increased accessibility and better care through telemedicine will become a new normal for the future of healthcare delivery. The Centers for Medicare and Medicaid Services (CMS) Administrator, Seema Verma stated, “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”

      Is your organization prepared for the future of telemedicine? If your healthcare organization is in need of provider credentialing to support the screening of your telehealth providers, contact Verisys. Our premium technology and unmatched provider data are here to help your organization mitigate risk and continue providing the best patient care in the next phase of telehealth.

      Juliette Willard Written by Juliette Willard
      Healthcare Communications Specialist
      Being creative is my passion! Writer. Painter. Problem Solver. Optimist.
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