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Great

work, ! Hopefully, that will spread east!

virtual office visits

Yippee!!

It’s official – Kaiser of Colorado Springs has

agreed to reimburse me $50 for each phone visit and virtual office visit

(email) done by their members starting 1/1/2007. Kaiser has been paying

for my $60 annual fee/person (which will be gone as of 2007) and $20 for each

virtual office visit. At least one insurer is paying for alternative

medical visits.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO 80863

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Way to go .

While few of us are lucky enough to live in a region where enlightened

insurers recognize the value of our work and are willing to pay for it,

we have to thank for setting up a fabulous practice and working

diligently to prove the worth.

Think about making the case to your local IPA/insurer. Making such

a case is based on being able to show that you're doing extraordinary

work.

One of the most powerful means to demonstrating excellent population

based care is to show that you have the key processes in place:

24/7 access

Opportunistic and planned care

Robust non-visit options for care (when appropriate)

transparent measurement system in place.

One of the best measurement systems I have come across (in part due to

the ease of use and cost) is HowsYourHealth.org

has all of these components working in her practice.

Gordon

At 10:46 PM 12/17/2006, you wrote:

Yippee!!

It’s official – Kaiser of Colorado Springs has agreed to

reimburse me $50 for each phone visit and virtual office visit (email)

done by their members starting 1/1/2007. Kaiser has been paying for

my $60 annual fee/person (which will be gone as of 2007) and $20 for each

virtual office visit. At least one insurer is paying for

alternative medical visits.

A. Eads,

M.D.

Pinnacle Family

Medicine, PLLC

phone

fax

P.O. Box

7275

Woodland Park,

CO 80863

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Bravo! Beware as the news becomes public in your community. My friend Rushika in Boston caught a lot of flak from local hospitals, staff and colleagues for getting "paid extra" for services a lot of other docs feel like they provide (becasue they do it once in a great while whereas you do it all day long everyday). I am very happy for you. It is well deserved. Bob Eads wrote: Yippee!! It’s official – Kaiser of Colorado Springs has agreed to reimburse me $50 for each phone visit and virtual office visit (email) done by their members starting 1/1/2007. Kaiser has been paying for my $60 annual fee/person (which will be gone as of 2007) and $20 for each virtual office visit. At least one insurer is paying for alternative medical visits. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 __________________________________________________

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Right,

and that presents a question: is Dr. Eads the only one Kaiser has agreed to pay

for these or is it their new blanket policy? That is a lot for a phone visit!

What parameters constitute a “visit” and how is that different from

a “non-visit” phone call (ie, refill request, discuss lab result,

etc). What is an “alternative medical visit” exactly?

Re:

virtual office visits

Bravo! Beware as the news becomes public in your

community. My friend Rushika in Boston caught a lot of flak from local

hospitals, staff and colleagues for getting " paid extra " for services

a lot of other docs feel like they provide (becasue they do it once in a great

while whereas you do it all day long everyday). I am very happy for you. It is

well deserved.

Bob

Eads

<michelle.eadsworldnet (DOT) att.net> wrote:

Yippee!!

It’s official –

Kaiser of Colorado Springs has agreed to reimburse me $50 for each phone visit

and virtual office visit (email) done by their members starting 1/1/2007.

Kaiser has been paying for my $60 annual fee/person (which will be gone as of

2007) and $20 for each virtual office visit. At least one insurer is

paying for alternative medical visits.

A. Eads, M.D.

Pinnacle

Family Medicine, PLLC

phone fax

P.O. Box

7275

Woodland Park,

CO 80863

__________________________________________________

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Share on other sites

Congrats Michele

and

thanks...

I was not feeling greatly interested in VOV but well I guess I am.I do

some e mail with patietns and it is so easy , might as well expand to

clinical stuff and get paid..Nice for patietns.Nice for me.

I just called my only insurance co Anthem/Blue cross a big player here,

and asked about htis . Got the rep's voice mail but YOU Michele give us now

a refernece- " kaiser is doing this.. " plus a littel bit of weight i get to

throw down having been in t he local papers and in medical economics.

will let you know what happens.

Also re my move -- I hope to go to the next building owned by Kim the

internist, although it is basementy... She is nice but never overtly

frinedly only recpetively friendly... Yesterday I find a copy of medical

economics in my box with a note " extra copy for your family. " and that

she spoke to the CEO of the hopsitl about t he situation. Which is above

and beyond.

God it is good to have people help.(Wuz i allowed to say god on email??)

Re: virtual office visits

Bravo! Beware as the news becomes public in your community. My friend

Rushika in Boston caught a lot of flak from local hospitals, staff and

colleagues for getting " paid extra " for services a lot of other docs

feel like they provide (becasue they do it once in a great while whereas

you do it all day long everyday). I am very happy for you. It is well

deserved.

Bob

Eads wrote:

Yippee!!

It's official - Kaiser of Colorado Springs has agreed to reimburse me

$50 for each phone visit and virtual office visit (email) done by their

members starting 1/1/2007. Kaiser has been paying for my $60 annual

fee/person (which will be gone as of 2007) and $20 for each virtual

office visit. At least one insurer is paying for alternative medical

visits.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO 80863

__________________________________________________

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Share on other sites

My understanding is that I am the only

physician in the Colorado Springs Kaiser plan that is being paid for this

service. The Kaiser medical director for Colorado Springs, the admin (QA) person and

finance person for the Col Springs office all agreed to do this. This has

been a pilot program since I started my practice (7/03). They (Kaiser) do

reimburse their own Kaiser docs (in Denver)

$16 for ‘email visits’ which I believe (from what the medical

director said) includes simple visits like ‘cont to take your chol med’

when asked by a pt, and not necessarily involves evaluation of labs, dosage

changes, etc. I suspect they would be more in line with 99212

visits.

Kaiser of CS is a different Kaiser animal –

no Kaiser building/hospital/docs – they contract with the community for

everything. They have been monitoring/studying my use of VOVs (with my

permission and support) in the form of printed out versions of my online

visits. My VOVs are for UTIs, URI/sinus/bronchitis, emergency

contraception, recurrent back pain, HTN f/u, etc. Can include attachments

for word or excel documents, pics for moles and rashes, and even wave file (one

guy recorded his cough, and it was helpful). They nearly always include a

medical evaluation that results in a new medication, dosage change, or continuation

of a med if it is controlling their condition. They take me 16 mins on

average to do. They are quick because the pt has answered all the

questions and they are presented to me concisely. They are not just ‘fluff’

visits – they would usually be a 99213 or 99214 had they been in the

office.

Normal lab/imaging/etc results, or ones

that don’t trigger a change in meds, are relayed to the pt (they get a

copy of it with my interpretation), for no charge. Ones that do trigger a

change can be done via a phone visit. I’ve just started doing the phone

visits, and they usually run 15 mins, the pt has a copy of their info in front

of them, and are scheduled. I use the term ‘alternative medical

visit’ (just came up with it) to mean alternative to an (in) office

visit. I’ve found some of my pts had a hard time doing the VOVs

when they were sick (put in a space before the character, got an error, got

frustrated, etc), or don’t always have access to internet (traveling).

Some issues lend themselves more to the open give and take communication of a

phone visit (like discussing abn test results) while others are better (easier

and more efficient for me) if they are done as VOVs where the information

(history) is already gathered.

I priced these visits @ $50 for 15 minutes

of my time, and it is less than the reimbursement for a 99213 for my area (to

make it cost effective for the insurance companies). Pts that don’t

have Kaiser will pay $50, is always an option, and they are welcome to a ‘traditional’

OV if they prefer.

Hopefully this will have a snowball effect

– I have another insurance group that is looking into covering these as

well.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of Brock DO

Sent: Tuesday, December 19, 2006

8:58 AM

To:

Subject: RE:

virtual office visits

Right, and that presents a question: is Dr. Eads the only one

Kaiser has agreed to pay for these or is it their new blanket policy?

That is a lot for a phone visit! What parameters constitute a

“visit” and how is that different from a “non-visit”

phone call (ie, refill request, discuss lab result, etc). What is an

“alternative medical visit” exactly?

-----Original

Message-----

From:

[mailto: ]

On Behalf Of Forester

Sent: Tuesday, December 19, 2006

10:49 AM

To:

Subject: Re:

virtual office visits

Bravo! Beware

as the news becomes public in your community. My friend Rushika in Boston

caught a lot of flak from local hospitals, staff and colleagues for getting

" paid extra " for services a lot of other docs feel like they provide

(becasue they do it once in a great while whereas you do it all day long everyday).

I am very happy for you. It is well deserved.

Bob

Eads

<michelle.eadsworldnet (DOT) att.net> wrote:

Yippee!!

It’s

official – Kaiser of Colorado Springs has agreed to reimburse me $50 for

each phone visit and virtual office visit (email) done by their members

starting 1/1/2007. Kaiser has been paying for my $60 annual fee/person

(which will be gone as of 2007) and $20 for each virtual office visit. At

least one insurer is paying for alternative medical visits.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO

80863

__________________________________________________

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Share on other sites

You, Michele, are awesome!

Thanks for that full explanation. I can't imagine how much effort you've

put into getting this to become real. I remember a few years ago when you

discussed having insurance medical directors over for visits ( I think

that was you?) and getting them to understand what you do and why it's

worthwhile. Now this.

Thanks for all your good work. It may help us all over time. And I admit

to currently having the desire to absolutely avoid all insurance

administators... I don't know how you could be so patient with them!

You are a good soul obviously.

Tim

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(phone / fax)

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> My understanding is that I am the only physician in the Colorado Springs

> Kaiser plan that is being paid for this service. The Kaiser medical

> director for Colorado Springs, the admin (QA) person and finance person

> for the Col Springs office all agreed to do this. This has been a pilot

> program since I started my practice (7/03). They (Kaiser) do reimburse

> their own Kaiser docs (in Denver) $16 for 'email visits' which I believe

> (from what the medical director said) includes simple visits like 'cont

> to take your chol med' when asked by a pt, and not necessarily involves

> evaluation of labs, dosage changes, etc. I suspect they would be more

> in line with 99212 visits.

>

>

>

> Kaiser of CS is a different Kaiser animal - no Kaiser

> building/hospital/docs - they contract with the community for

> everything. They have been monitoring/studying my use of VOVs (with my

> permission and support) in the form of printed out versions of my online

> visits. My VOVs are for UTIs, URI/sinus/bronchitis, emergency

> contraception, recurrent back pain, HTN f/u, etc. Can include

> attachments for word or excel documents, pics for moles and rashes, and

> even wave file (one guy recorded his cough, and it was helpful). They

> nearly always include a medical evaluation that results in a new

> medication, dosage change, or continuation of a med if it is controlling

> their condition. They take me 16 mins on average to do. They are quick

> because the pt has answered all the questions and they are presented to

> me concisely. They are not just 'fluff' visits - they would usually be

> a 99213 or 99214 had they been in the office.

>

>

>

> Normal lab/imaging/etc results, or ones that don't trigger a change in

> meds, are relayed to the pt (they get a copy of it with my

> interpretation), for no charge. Ones that do trigger a change can be

> done via a phone visit. I've just started doing the phone visits, and

> they usually run 15 mins, the pt has a copy of their info in front of

> them, and are scheduled. I use the term 'alternative medical visit'

> (just came up with it) to mean alternative to an (in) office visit.

> I've found some of my pts had a hard time doing the VOVs when they were

> sick (put in a space before the character, got an error, got frustrated,

> etc), or don't always have access to internet (traveling). Some issues

> lend themselves more to the open give and take communication of a phone

> visit (like discussing abn test results) while others are better (easier

> and more efficient for me) if they are done as VOVs where the

> information (history) is already gathered.

>

>

>

> I priced these visits @ $50 for 15 minutes of my time, and it is less

> than the reimbursement for a 99213 for my area (to make it cost

> effective for the insurance companies). Pts that don't have Kaiser will

> pay $50, is always an option, and they are welcome to a 'traditional' OV

> if they prefer.

>

>

>

> Hopefully this will have a snowball effect - I have another insurance

> group that is looking into covering these as well.

>

>

>

> A. Eads, M.D.

>

> Pinnacle Family Medicine, PLLC

>

> phone fax

>

> P.O. Box 7275

>

> Woodland Park, CO 80863

>

> _____

>

> From:

> [mailto: ] On Behalf Of Brock

> DO Sent: Tuesday, December 19, 2006 8:58 AM

> To:

> Subject: RE: virtual office visits

>

>

>

> Right, and that presents a question: is Dr. Eads the only one Kaiser has

> agreed to pay for these or is it their new blanket policy? That is a

> lot for a phone visit! What parameters constitute a " visit " and how is

> that different from a " non-visit " phone call (ie, refill request,

> discuss lab result, etc). What is an " alternative medical visit "

> exactly?

>

>

>

>

>

>

>

> Re: virtual office visits

>

>

>

> Bravo! Beware as the news becomes public in your community. My friend

> Rushika in Boston caught a lot of flak from local hospitals, staff and

> colleagues for getting " paid extra " for services a lot of other docs

> feel like they provide (becasue they do it once in a great while whereas

> you do it all day long everyday). I am very happy for you. It is well

> deserved.

>

> Bob

>

> Eads wrote:

>

> Yippee!!

>

> It's official - Kaiser of Colorado Springs has agreed to reimburse me

> $50 for each phone visit and virtual office visit (email) done by their

> members starting 1/1/2007. Kaiser has been paying for my $60 annual

> fee/person (which will be gone as of 2007) and $20 for each virtual

> office visit. At least one insurer is paying for alternative medical

> visits.

>

> A. Eads, M.D.

>

> Pinnacle Family Medicine, PLLC

>

> phone fax

>

> P.O. Box 7275

>

> Woodland Park, CO 80863

>

>

>

> __________________________________________________

>

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,

This is a stunning way of seeing patients

(without actually seeing them). I am truly impressed by your continued ingenuity.

Thanks for explaining this system! Very cool!

Re:

virtual office visits

Bravo! Beware as the news becomes public in your community. My

friend Rushika in Boston caught a lot of flak from local hospitals, staff and

colleagues for getting " paid extra " for services a lot of other docs

feel like they provide (becasue they do it once in a great while whereas you do

it all day long everyday). I am very happy for you. It is well deserved.

Bob

Eads

<michelle.eadsworldnet (DOT) att.net> wrote:

Yippee!!

It’s official – Kaiser of Colorado

Springs has agreed to reimburse me $50 for each phone visit and virtual office

visit (email) done by their members starting 1/1/2007. Kaiser has been

paying for my $60 annual fee/person (which will be gone as of 2007) and $20 for

each virtual office visit. At least one insurer is paying for alternative

medical visits.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO

80863

__________________________________________________

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Share on other sites

These

VOV’s sound great in some ways, but boy I am still a bit leary of any

trend towards “virtual medicine” without a face to face

encounter. I am still of the mindset that medicine is practiced face to

face & VOV’s are a slippery slope to be starting down. It seems

slightly analogous to the “Minute Clinic” concept to me: a

generally sound & accepted concept whose time has come . . . until some major

medical catastrophe happens (ie, “it just sounded like something so

routine, I guess it was not conveyed properly.”). Example: sounded

like bronchitis over the phone but ended up being CHF, PE, etc, etc. Maybe I

just do not understand these VOV’s yet, so I’ll try to keep an open

mind about them. Besides, 16 minutes is still quite a bit of time to

spend, and that time adds up. An efficient doc can see a 99214 level

visit in 12 minutes, but leave the option open of spending more face to face

time if indicated/needed. If those were an option here in Ohio I am still not sure I

would opt to do them instead of a face to face visit. Still, it is

impressive that Kaiser has listened to you & recognized your cutting-edge

practice style (IMP).

Re:

virtual office visits

Bravo! Beware as the news becomes public in your

community. My friend Rushika in Boston caught a lot of flak from local

hospitals, staff and colleagues for getting " paid extra " for services

a lot of other docs feel like they provide (becasue they do it once in a great

while whereas you do it all day long everyday). I am very happy for you. It is

well deserved.

Bob

Eads

<michelle.eadsworldnet (DOT) att.net> wrote:

Yippee!!

It’s official –

Kaiser of Colorado Springs has agreed to reimburse me $50 for each phone visit

and virtual office visit (email) done by their members starting 1/1/2007.

Kaiser has been paying for my $60 annual fee/person (which will be gone as of

2007) and $20 for each virtual office visit. At least one insurer is

paying for alternative medical visits.

A. Eads, M.D.

Pinnacle

Family Medicine, PLLC

phone fax

P.O. Box

7275

Woodland Park,

CO 80863

__________________________________________________

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Share on other sites

so for billing and coding purposes, what is your location code, the office? LL Eads wrote: My understanding is that I am the only physician in the Colorado Springs Kaiser plan that is being paid for this service. The Kaiser medical director for Colorado Springs, the admin

(QA) person and finance person for the Col Springs office all agreed to do this. This has been a pilot program since I started my practice (7/03). They (Kaiser) do reimburse their own Kaiser docs (in Denver) $16 for ‘email visits’ which I believe (from what the medical director said) includes simple visits like ‘cont to take your chol med’ when asked by a pt, and not necessarily involves evaluation of labs, dosage changes, etc. I suspect they would be more in line with 99212 visits. Kaiser of CS is a different Kaiser animal – no Kaiser building/hospital/docs – they contract with the community for everything. They have been

monitoring/studying my use of VOVs (with my permission and support) in the form of printed out versions of my online visits. My VOVs are for UTIs, URI/sinus/bronchitis, emergency contraception, recurrent back pain, HTN f/u, etc. Can include attachments for word or excel documents, pics for moles and rashes, and even wave file (one guy recorded his cough, and it was helpful). They nearly always include a medical evaluation that results in a new medication, dosage change, or continuation of a med if it is controlling their condition. They take me 16 mins on average to do. They are quick because the pt has answered all the questions and they are presented to me concisely. They are not just ‘fluff’ visits – they would usually be a 99213 or 99214 had they been in the office. Normal lab/imaging/etc results, or ones that don’t trigger a change in meds, are relayed to the pt (they get a copy of it with my interpretation), for no charge. Ones that do trigger a change can be done via a phone visit. I’ve just started doing the phone visits, and they usually run 15 mins, the pt has a copy of their info in front of them, and are scheduled. I use the term ‘alternative medical visit’ (just came up with it) to mean alternative to an (in) office visit. I’ve found some of my pts had a hard time doing the VOVs when they were sick (put in a space before the character, got an error, got frustrated, etc), or don’t always have access to internet (traveling). Some issues lend themselves more to the open give and take communication of a phone visit (like discussing abn

test results) while others are better (easier and more efficient for me) if they are done as VOVs where the information (history) is already gathered. I priced these visits @ $50 for 15 minutes of my time, and it is less than the reimbursement for a 99213 for my area (to make it cost effective for the insurance companies). Pts that don’t have Kaiser will pay $50, is always an option, and they are welcome to a ‘traditional’ OV if they prefer. Hopefully this will have a snowball effect – I have another insurance group that is looking into covering these as well. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Brock DOSent: Tuesday, December 19, 2006 8:58 AMTo: Subject: RE: virtual office visits Right, and that presents a question: is Dr. Eads the only one Kaiser

has agreed to pay for these or is it their new blanket policy? That is a lot for a phone visit! What parameters constitute a “visit” and how is that different from a “non-visit” phone call (ie, refill request, discuss lab result, etc). What is an “alternative medical visit” exactly? -----Original Message-----From:

[mailto: ] On Behalf Of ForesterSent: Tuesday, December 19, 2006 10:49 AMTo: Subject: Re: virtual office visits Bravo! Beware as the news becomes public in your community. My friend Rushika in Boston caught a lot of flak from local hospitals, staff and colleagues for getting

"paid extra" for services a lot of other docs feel like they provide (becasue they do it once in a great while whereas you do it all day long everyday). I am very happy for you. It is well deserved. Bob Eads <michelle.eadsworldnet (DOT) att.net> wrote: Yippee!! It’s official – Kaiser of Colorado Springs has agreed to reimburse me $50 for each phone visit and

virtual office visit (email) done by their members starting 1/1/2007. Kaiser has been paying for my $60 annual fee/person (which will be gone as of 2007) and $20 for each virtual office visit. At least one insurer is paying for alternative medical visits. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 __________________________________________________

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i agree, the most impressive part of this is that an insurance company listened. perhaps there's hope after all. LL Brock DO wrote: These VOV’s sound great in some ways, but boy I am still a bit leary of any trend towards “virtual medicine” without a face to face encounter. I am

still of the mindset that medicine is practiced face to face & VOV’s are a slippery slope to be starting down. It seems slightly analogous to the “Minute Clinic” concept to me: a generally sound & accepted concept whose time has come . . . until some major medical catastrophe happens (ie, “it just sounded like something so routine, I guess it was not conveyed properly.”). Example: sounded like bronchitis over the phone but ended up being CHF, PE, etc, etc. Maybe I just do not understand these VOV’s yet, so

I’ll try to keep an open mind about them. Besides, 16 minutes is still quite a bit of time to spend, and that time adds up. An efficient doc can see a 99214 level visit in 12 minutes, but leave the option open of spending more face to face time if indicated/needed. If those were an option here in Ohio I am still not sure I would opt to do them instead of a face to face visit. Still, it is impressive that Kaiser has listened to you & recognized your cutting-edge practice style (IMP). -----Original Message-----From: [mailto: ] On Behalf Of EadsSent: Tuesday, December 19, 2006 10:40 PMTo: Subject: RE: virtual office visits My understanding is that I am the only physician in the Colorado Springs Kaiser plan that is being paid for this service. The Kaiser medical director for Colorado Springs, the admin (QA) person and finance person for the Col Springs office all agreed to do this. This has been a pilot program since I started my practice (7/03). They (Kaiser) do reimburse their own Kaiser docs (in Denver) $16 for ‘email visits’ which I believe (from what the medical director said) includes simple visits like ‘cont to take your chol med’ when asked by a pt, and not necessarily involves evaluation of labs, dosage changes, etc. I suspect they would be more in line with 99212 visits.

Kaiser of CS is a different Kaiser animal – no Kaiser building/hospital/docs – they contract with the community for everything. They have been monitoring/studying my use of VOVs (with my permission and support) in the form of printed out versions of my online visits. My VOVs are for UTIs, URI/sinus/bronchitis, emergency contraception, recurrent back pain, HTN f/u, etc. Can include attachments for word or excel documents, pics for moles and rashes, and even wave file (one guy recorded his cough, and it was helpful). They nearly always include a medical evaluation that results in a new medication, dosage change, or continuation of a med if it is

controlling their condition. They take me 16 mins on average to do. They are quick because the pt has answered all the questions and they are presented to me concisely. They are not just ‘fluff’ visits – they would usually be a 99213 or 99214 had they been in the office. Normal lab/imaging/etc results, or ones that don’t trigger a change in meds, are relayed to the pt (they get a copy of it with my interpretation), for no charge. Ones that do trigger a change can be done via a phone visit. I’ve just started doing the phone visits, and they usually run 15 mins, the pt has a copy of their info in front of them, and are scheduled. I

use the term ‘alternative medical visit’ (just came up with it) to mean alternative to an (in) office visit. I’ve found some of my pts had a hard time doing the VOVs when they were sick (put in a space before the character, got an error, got frustrated, etc), or don’t always have access to internet (traveling). Some issues lend themselves more to the open give and take communication of a phone visit (like discussing abn test results) while others are better (easier and more efficient for me) if they are done as VOVs where the information (history) is already gathered. I priced these visits @ $50 for 15 minutes of my time, and it is less than the reimbursement for a 99213

for my area (to make it cost effective for the insurance companies). Pts that don’t have Kaiser will pay $50, is always an option, and they are welcome to a ‘traditional’ OV if they prefer. Hopefully this will have a snowball effect – I have another insurance group that is looking into covering these as well. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Brock DOSent: Tuesday, December 19, 2006 8:58 AMTo: Subject: RE: virtual office visits Right, and that presents a question: is Dr. Eads the only one Kaiser has agreed to pay for these or is it their new blanket policy? That is a lot for a phone visit! What parameters constitute a “visit” and how is that different from a “non-visit” phone call (ie, refill request, discuss lab result, etc). What is an “alternative medical visit” exactly? -----Original

Message-----From: [mailto: ] On Behalf Of ForesterSent: Tuesday, December 19, 2006 10:49 AMTo: Subject: Re: virtual office visits Bravo! Beware as the news becomes public in your community. My friend Rushika in Boston caught a

lot of flak from local hospitals, staff and colleagues for getting "paid extra" for services a lot of other docs feel like they provide (becasue they do it once in a great while whereas you do it all day long everyday). I am very happy for you. It is well deserved. Bob Eads <michelle.eadsworldnet (DOT) att.net> wrote: Yippee!! It’s official – Kaiser of

Colorado Springs has agreed to reimburse me $50 for each phone visit and virtual office visit (email) done by their members starting 1/1/2007. Kaiser has been paying for my $60 annual fee/person (which will be gone as of 2007) and $20 for each virtual office visit. At least one insurer is paying for alternative medical visits. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 __________________________________________________

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Dear , I was a Board Officer of the Kaiser Stanislaus Provider Network (now ~90K lives) from 1996-2001. We too started out as a totally subcontracted entity. They told us we would be just like CO Springs and another network in GA or NC, but the first in California. We too had no Kaiser building/hospital/docs. On Wednesday evenings for five years I helped work to build the network. Once in a while, a few paranoid doctors from Southern California, Bakersfield and the Marin area told us, "Beware! They'll bait-and-switch you!" Pish-posh, I thought. When the leadership changed, the structure changed. The dynamic "new" form of Kaiser was thrown out the window. Their clinics sprouted all over the county over 2-3 years and the brand-new flagship hospital opens in 2008. We were promised the moon, but some docs got the shaft. If you were so inclined, I'd be happy to tell you more of the story. Beware, the Jabberwock, my son; the jaws that bite, the claws that catch. Beware the jub-jub bird and shun the frumious Bandersnatch! Great work, ! Just watch your tail-feathers! Eads wrote: My understanding is that I am the only physician in the Colorado

Springs Kaiser plan that is being paid for this service. The Kaiser medical director for Colorado Springs, the admin (QA) person and finance person for the Col Springs office all agreed to do this. This has been a pilot program since I started my practice (7/03). They (Kaiser) do reimburse their own Kaiser docs (in Denver) $16 for ‘email visits’ which I believe (from what the medical director said) includes simple visits like ‘cont to take your chol med’ when asked by a pt, and not necessarily involves evaluation of labs, dosage changes, etc. I suspect they would be more in line with 99212 visits. Kaiser of CS

is a different Kaiser animal – no Kaiser building/hospital/docs – they contract with the community for everything. They have been monitoring/studying my use of VOVs (with my permission and support) in the form of printed out versions of my online visits. My VOVs are for UTIs, URI/sinus/bronchitis, emergency contraception, recurrent back pain, HTN f/u, etc. Can include attachments for word or excel documents, pics for moles and rashes, and even wave file (one guy recorded his cough, and it was helpful). They nearly always include a medical evaluation that results in a new medication, dosage change, or continuation of a med if it is controlling their condition. They take me 16 mins on average to do. They are quick because the pt has answered all the questions and they are presented to me concisely. They are not just ‘fluff’ visits – they would usually be a 99213 or 99214 had they been in the office.

Normal lab/imaging/etc results, or ones that don’t trigger a change in meds, are relayed to the pt (they get a copy of it with my interpretation), for no charge. Ones that do trigger a change can be done via a phone visit. I’ve just started doing the phone visits, and they usually run 15 mins, the pt has a copy of their info in front of them, and are scheduled. I use the term ‘alternative medical visit’ (just came up with it) to mean alternative to an (in) office visit. I’ve found some of my pts had a hard time doing the VOVs when they were sick (put in a space before the character, got an error, got frustrated, etc), or don’t always have access to

internet (traveling). Some issues lend themselves more to the open give and take communication of a phone visit (like discussing abn test results) while others are better (easier and more efficient for me) if they are done as VOVs where the information (history) is already gathered. I priced these visits @ $50 for 15 minutes of my time, and it is less than the reimbursement for a 99213 for my area (to make it cost effective for the insurance companies). Pts that don’t have Kaiser will pay $50, is always an option, and they are welcome to a ‘traditional’ OV if they prefer. Hopefully this will have a snowball effect – I have another insurance group that is looking into covering these as well. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Brock DOSent: Tuesday, December 19, 2006 8:58 AMTo: Subject: RE: virtual office visits Right, and that presents a question: is Dr. Eads the only one Kaiser has agreed to pay for these or is it their new blanket policy? That is a lot for a phone visit! What parameters constitute a “visit” and how is that different from a “non-visit” phone call (ie, refill request, discuss lab result, etc). What is an “alternative medical visit” exactly? -----Original Message-----From: [mailto: ] On Behalf Of ForesterSent: Tuesday, December 19, 2006 10:49 AMTo: Subject: Re: virtual office visits Bravo! Beware as the news becomes

public in your community. My friend Rushika in Boston caught a lot of flak from local hospitals, staff and colleagues for getting "paid extra" for services a lot of other docs feel like they provide (becasue they do it once in a great while whereas you do it all day long everyday). I am very happy for you. It is well deserved. Bob Eads <michelle.eadsworldnet (DOT) att.net> wrote: Yippee!! It’s official – Kaiser of Colorado Springs has agreed to reimburse me $50 for each phone visit and virtual office visit (email) done by their members starting 1/1/2007. Kaiser has been paying for my $60 annual fee/person (which will be gone as of 2007) and $20 for each virtual office visit. At least one insurer is paying for alternative medical visits. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone

fax P.O. Box 7275 Woodland Park, CO 80863 __________________________________________________Do You

Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com __________________________________________________

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Dear , Did I forget to mention that you are an IMP hero? A hall-of-famer from the word "go," -- an inspiration! Bob Forester Eads wrote: My understanding is that I am the only physician in the Colorado Springs Kaiser plan that is being paid for this service. The Kaiser

medical director for Colorado Springs, the admin (QA) person and finance person for the Col Springs office all agreed to do this. This has been a pilot program since I started my practice (7/03). They (Kaiser) do reimburse their own Kaiser docs (in Denver) $16 for ‘email visits’ which I believe (from what the medical director said) includes simple visits like ‘cont to take your chol med’ when asked by a pt, and not necessarily involves evaluation of labs, dosage changes, etc. I suspect they would be more in line with 99212 visits. Kaiser of CS is a different Kaiser animal – no Kaiser building/hospital/docs –

they contract with the community for everything. They have been monitoring/studying my use of VOVs (with my permission and support) in the form of printed out versions of my online visits. My VOVs are for UTIs, URI/sinus/bronchitis, emergency contraception, recurrent back pain, HTN f/u, etc. Can include attachments for word or excel documents, pics for moles and rashes, and even wave file (one guy recorded his cough, and it was helpful). They nearly always include a medical evaluation that results in a new medication, dosage change, or continuation of a med if it is controlling their condition. They take me 16 mins on average to do. They are quick because the pt has answered all the questions and they are presented to me concisely. They are not just ‘fluff’ visits – they would usually be a 99213 or 99214 had they been in the office. Normal lab/imaging/etc results, or ones that don’t trigger a change in meds, are relayed to the pt (they get a copy of it with my interpretation), for no charge. Ones that do trigger a change can be done via a phone visit. I’ve just started doing the phone visits, and they usually run 15 mins, the pt has a copy of their info in front of them, and are scheduled. I use the term ‘alternative medical visit’ (just came up with it) to mean alternative to an (in) office visit. I’ve found some of my pts had a hard time doing the VOVs when they were sick (put in a space before the character, got an error, got frustrated, etc), or don’t always have access to internet (traveling). Some issues lend themselves more to the open give

and take communication of a phone visit (like discussing abn test results) while others are better (easier and more efficient for me) if they are done as VOVs where the information (history) is already gathered. I priced these visits @ $50 for 15 minutes of my time, and it is less than the reimbursement for a 99213 for my area (to make it cost effective for the insurance companies). Pts that don’t have Kaiser will pay $50, is always an option, and they are welcome to a ‘traditional’ OV if they prefer. Hopefully this will have a snowball effect – I have another insurance group that is looking into covering these as well. A. Eads, M.D. Pinnacle Family Medicine, PLLC (719)

687-8752 phone fax P.O. Box 7275 Woodland Park, CO 80863 From: [mailto: ] On Behalf Of Brock DOSent: Tuesday, December 19, 2006 8:58 AMTo: Subject: RE: virtual office visits Right, and that

presents a question: is Dr. Eads the only one Kaiser has agreed to pay for these or is it their new blanket policy? That is a lot for a phone visit! What parameters constitute a “visit” and how is that different from a “non-visit” phone call (ie, refill request, discuss lab result, etc). What is an “alternative medical visit” exactly? -----Original Message-----From: [mailto: ] On Behalf Of ForesterSent: Tuesday, December 19, 2006 10:49 AMTo: Subject: Re: virtual office visits Bravo! Beware as the news becomes public in your community. My friend Rushika in Boston caught a lot of flak from local hospitals, staff and

colleagues for getting "paid extra" for services a lot of other docs feel like they provide (becasue they do it once in a great while whereas you do it all day long everyday). I am very happy for you. It is well deserved. Bob Eads <michelle.eadsworldnet (DOT) att.net> wrote: Yippee!! It’s official – Kaiser of Colorado Springs has agreed to reimburse me $50

for each phone visit and virtual office visit (email) done by their members starting 1/1/2007. Kaiser has been paying for my $60 annual fee/person (which will be gone as of 2007) and $20 for each virtual office visit. At least one insurer is paying for alternative medical visits. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 __________________________________________________

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That is me you are thinking of. I hope

that others can use Kaiser as an example and get this happening in more parts

of the country (happening in FL, NC, CA, OH to my knowledge, and wherever Chuck

Kilo is). Kaiser is studying the info on my VOVs as we speak, and I anticipate

it will be quite good from the insurance perspective (cost and quality of

care). I’ll pass that on when I get any info on it.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of Malia, MD

Sent: Tuesday, December 19, 2006

9:13 PM

To:

Subject: RE:

virtual office visits

You, Michele, are awesome!

Thanks for that full explanation. I can't imagine how much effort you've

put into getting this to become real. I remember a few years ago when you

discussed having insurance medical directors over for visits ( I think

that was you?) and getting them to understand what you do and why it's

worthwhile. Now this.

Thanks for all your good work. It may help us all over time. And I admit

to currently having the desire to absolutely avoid all insurance

administators... I don't know how you could be so patient with them!

You are a good soul obviously.

Tim

--

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY

14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use of

the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the intended

recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the

sender immediately by reply email and destroy all copies of the original

message, including attachments.

> My understanding is that I am the only physician in the Colorado Springs

> Kaiser plan that is being paid for this service. The Kaiser medical

> director for Colorado Springs,

the admin (QA) person and finance person

> for the Col Springs office all agreed to do this. This has been a pilot

> program since I started my practice (7/03). They (Kaiser) do reimburse

> their own Kaiser docs (in Denver)

$16 for 'email visits' which I believe

> (from what the medical director said) includes simple visits like 'cont

> to take your chol med' when asked by a pt, and not necessarily involves

> evaluation of labs, dosage changes, etc. I suspect they would be more

> in line with 99212 visits.

>

>

>

> Kaiser of CS is a different Kaiser animal - no Kaiser

> building/hospital/docs - they contract with the community for

> everything. They have been monitoring/studying my use of VOVs (with my

> permission and support) in the form of printed out versions of my online

> visits. My VOVs are for UTIs, URI/sinus/bronchitis, emergency

> contraception, recurrent back pain, HTN f/u, etc. Can include

> attachments for word or excel documents, pics for moles and rashes, and

> even wave file (one guy recorded his cough, and it was helpful). They

> nearly always include a medical evaluation that results in a new

> medication, dosage change, or continuation of a med if it is controlling

> their condition. They take me 16 mins on average to do. They are quick

> because the pt has answered all the questions and they are presented to

> me concisely. They are not just 'fluff' visits - they would usually be

> a 99213 or 99214 had they been in the office.

>

>

>

> Normal lab/imaging/etc results, or ones that don't trigger a change

in

> meds, are relayed to the pt (they get a copy of it with my

> interpretation), for no charge. Ones that do trigger a change can be

> done via a phone visit. I've just started doing the phone visits, and

> they usually run 15 mins, the pt has a copy of their info in front of

> them, and are scheduled. I use the term 'alternative medical visit'

> (just came up with it) to mean alternative to an (in) office visit.

> I've found some of my pts had a hard time doing the VOVs when they were

> sick (put in a space before the character, got an error, got frustrated,

> etc), or don't always have access to internet (traveling). Some issues

> lend themselves more to the open give and take communication of a phone

> visit (like discussing abn test results) while others are better (easier

> and more efficient for me) if they are done as VOVs where the

> information (history) is already gathered.

>

>

>

> I priced these visits @ $50 for 15 minutes of my time, and it is less

> than the reimbursement for a 99213 for my area (to make it cost

> effective for the insurance companies). Pts that don't have Kaiser will

> pay $50, is always an option, and they are welcome to a 'traditional' OV

> if they prefer.

>

>

>

> Hopefully this will have a snowball effect - I have another insurance

> group that is looking into covering these as well.

>

>

>

> A. Eads, M.D.

>

> Pinnacle Family Medicine, PLLC

>

> phone fax

>

> P.O. Box 7275

>

> Woodland Park, CO 80863

>

> _____

>

> From:

> [mailto: ]

On Behalf Of Brock

> DO Sent: Tuesday, December 19, 2006 8:58 AM

> To:

> Subject: RE: virtual office visits

>

>

>

> Right, and that presents a question: is Dr. Eads the only one Kaiser has

> agreed to pay for these or is it their new blanket policy? That is a

> lot for a phone visit! What parameters constitute a " visit " and

how is

> that different from a " non-visit " phone call (ie, refill

request,

> discuss lab result, etc). What is an " alternative medical visit "

> exactly?

>

>

>

>

>

>

>

> Re: virtual office visits

>

>

>

> Bravo! Beware as the news becomes public in your community. My friend

> Rushika in Boston

caught a lot of flak from local hospitals, staff and

> colleagues for getting " paid extra " for services a lot of other

docs

> feel like they provide (becasue they do it once in a great while whereas

> you do it all day long everyday). I am very happy for you. It is well

> deserved.

>

> Bob

>

> Eads <michelle.eadsworldnet (DOT) att.net>

wrote:

>

> Yippee!!

>

> It's official - Kaiser of Colorado Springs has agreed to reimburse me

> $50 for each phone visit and virtual office visit (email) done by their

> members starting 1/1/2007. Kaiser has been paying for my $60 annual

> fee/person (which will be gone as of 2007) and $20 for each virtual

> office visit. At least one insurer is paying for alternative medical

> visits.

>

> A. Eads, M.D.

>

> Pinnacle Family Medicine, PLLC

>

> phone fax

>

> P.O. Box 7275

>

> Woodland Park, CO 80863

>

>

>

> __________________________________________________

>

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Share on other sites

Because I only have 400 pts, I know them

very well, and this helps with my comfort level in doing VOVs (established pts

only). I also have an educated and well-controlled chronic disease population

who have (so far) used the VOVs appropriately.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of Brock DO

Sent: Wednesday, December 20, 2006

6:58 AM

To:

Subject: RE:

virtual office visits

These VOV’s sound great in some ways, but boy I am still a

bit leary of any trend towards “virtual medicine” without a face to

face encounter. I am still of the mindset that medicine is practiced face

to face & VOV’s are a slippery slope to be starting down. It

seems slightly analogous to the “Minute Clinic” concept to me: a

generally sound & accepted concept whose time has come . . . until some

major medical catastrophe happens (ie, “it just sounded like something so

routine, I guess it was not conveyed properly.”). Example: sounded

like bronchitis over the phone but ended up being CHF, PE,

etc, etc. Maybe I just do not understand these VOV’s yet, so

I’ll try to keep an open mind about them. Besides, 16 minutes is

still quite a bit of time to spend, and that time adds up. An efficient

doc can see a 99214 level visit in 12 minutes, but leave the option open of

spending more face to face time if indicated/needed. If those were an

option here in Ohio

I am still not sure I would opt to do them instead of a face to face

visit. Still, it is impressive that Kaiser has listened to you &

recognized your cutting-edge practice style (IMP).

-----Original

Message-----

From:

[mailto: ]

On Behalf Of Eads

Sent: Tuesday, December 19, 2006

10:40 PM

To:

Subject: RE:

virtual office visits

My understanding is that I am the only physician in the Colorado

Springs Kaiser plan that is being paid for this service. The Kaiser

medical director for Colorado

Springs, the admin (QA) person and finance

person for the Col Springs office all agreed to do this. This has been a

pilot program since I started my practice (7/03). They (Kaiser) do

reimburse their own Kaiser docs (in Denver) $16 for ‘email

visits’ which I believe (from what the medical director said) includes

simple visits like ‘cont to take your chol med’ when asked by a pt,

and not necessarily involves evaluation of labs, dosage changes, etc. I

suspect they would be more in line with 99212 visits.

Kaiser of CS is a different Kaiser animal – no Kaiser

building/hospital/docs – they contract with the community for

everything. They have been monitoring/studying my use of VOVs (with my

permission and support) in the form of printed out versions of my online

visits. My VOVs are for UTIs, URI/sinus/bronchitis, emergency

contraception, recurrent back pain, HTN f/u, etc. Can include attachments

for word or excel documents, pics for moles and rashes, and even wave file (one

guy recorded his cough, and it was helpful). They nearly always include a

medical evaluation that results in a new medication, dosage change, or

continuation of a med if it is controlling their condition. They take me

16 mins on average to do. They are quick because the pt has answered all

the questions and they are presented to me concisely. They are not just

‘fluff’ visits – they would usually be a 99213 or 99214 had

they been in the office.

Normal lab/imaging/etc results, or ones that don’t

trigger a change in meds, are relayed to the pt (they get a copy of it with my

interpretation), for no charge. Ones that do trigger a change can be

done via a phone visit. I’ve just started doing the phone visits,

and they usually run 15 mins, the pt has a copy of their info in front of them,

and are scheduled. I use the term ‘alternative medical visit’

(just came up with it) to mean alternative to an (in) office visit.

I’ve found some of my pts had a hard time doing the VOVs when they were

sick (put in a space before the character, got an error, got frustrated, etc),

or don’t always have access to internet (traveling). Some issues

lend themselves more to the open give and take communication of a phone visit

(like discussing abn test results) while others are better (easier and more

efficient for me) if they are done as VOVs where the information (history) is

already gathered.

I priced these visits @ $50 for 15 minutes of my time, and it is

less than the reimbursement for a 99213 for my area (to make it cost effective

for the insurance companies). Pts that don’t have Kaiser will pay

$50, is always an option, and they are welcome to a ‘traditional’

OV if they prefer.

Hopefully this will have a snowball effect – I have another

insurance group that is looking into covering these as well.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO

80863

From:

[mailto: ]

On Behalf Of Brock DO

Sent: Tuesday, December 19, 2006

8:58 AM

To:

Subject: RE:

virtual office visits

Right, and that presents a question: is Dr. Eads the only one

Kaiser has agreed to pay for these or is it their new blanket policy?

That is a lot for a phone visit! What parameters constitute a

“visit” and how is that different from a “non-visit”

phone call (ie, refill request, discuss lab result, etc). What is an

“alternative medical visit” exactly?

-----Original

Message-----

From:

[mailto: ]

On Behalf Of Forester

Sent: Tuesday, December 19, 2006

10:49 AM

To:

Subject: Re:

virtual office visits

Bravo! Beware

as the news becomes public in your community. My friend Rushika in Boston

caught a lot of flak from local hospitals, staff and colleagues for getting

" paid extra " for services a lot of other docs feel like they provide

(becasue they do it once in a great while whereas you do it all day long

everyday). I am very happy for you. It is well deserved.

Bob

Eads

<michelle.eadsworldnet (DOT) att.net> wrote:

Yippee!!

It’s

official – Kaiser of Colorado Springs has agreed to reimburse me $50 for

each phone visit and virtual office visit (email) done by their members

starting 1/1/2007. Kaiser has been paying for my $60 annual fee/person

(which will be gone as of 2007) and $20 for each virtual office visit. At

least one insurer is paying for alternative medical visits.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO

80863

__________________________________________________

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Share on other sites

Geez, thanks. Like most of us on this

listserve, I’m just inspired by Gordon and keep trying to get better, and

help others benefit from it, too.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of Forester

Sent: Wednesday, December 20, 2006

5:17 PM

To:

Subject: RE:

virtual office visits

Dear ,

Did I forget to mention that you are an IMP hero? A hall-of-famer from

the word " go, " -- an inspiration!

Bob Forester

Eads

<michelle.eadsworldnet (DOT) att.net> wrote:

My understanding is that I am the only physician

in the Colorado Springs Kaiser plan that is being paid for this service.

The Kaiser medical director for Colorado

Springs, the admin (QA) person and finance

person for the Col Springs office all agreed to do this. This has been a

pilot program since I started my practice (7/03). They (Kaiser) do

reimburse their own Kaiser docs (in Denver) $16 for ‘email

visits’ which I believe (from what the medical director said) includes

simple visits like ‘cont to take your chol med’ when asked by a pt,

and not necessarily involves evaluation of labs, dosage changes, etc. I

suspect they would be more in line with 99212 visits.

Kaiser of CS is a different Kaiser

animal – no Kaiser building/hospital/docs – they contract with

the community for everything. They have been monitoring/studying my use

of VOVs (with my permission and support) in the form of printed out versions of

my online visits. My VOVs are for UTIs, URI/sinus/bronchitis,

emergency contraception, recurrent back pain, HTN f/u, etc. Can include attachments

for word or excel documents, pics for moles and rashes, and even wave file (one

guy recorded his cough, and it was helpful). They nearly always include a

medical evaluation that results in a new medication, dosage change, or

continuation of a med if it is controlling their condition. They take me

16 mins on average to do. They are quick because the pt has answered all

the questions and they are presented to me concisely. They are not just

‘fluff’ visits – they would usually be a 99213 or 99214 had

they been in the office.

Normal lab/imaging/etc

results, or ones that don’t trigger a change in meds, are relayed to the

pt (they get a copy of it with my interpretation), for no charge.

Ones that do trigger a change can be done via a phone visit. I’ve

just started doing the phone visits, and they usually run 15 mins, the pt has a

copy of their info in front of them, and are scheduled. I use the term

‘alternative medical visit’ (just came up with it) to mean alternative

to an (in) office visit. I’ve found some of my pts had a hard time

doing the VOVs when they were sick (put in a space before the character, got an

error, got frustrated, etc), or don’t always have access to internet

(traveling). Some issues lend themselves more to the open give and take

communication of a phone visit (like discussing abn test results) while others

are better (easier and more efficient for me) if they are done as VOVs where

the information (history) is already gathered.

I priced these visits @ $50 for 15

minutes of my time, and it is less than the reimbursement for a 99213 for my

area (to make it cost effective for the insurance companies). Pts that

don’t have Kaiser will pay $50, is always an option, and they are welcome

to a ‘traditional’ OV if they prefer.

Hopefully this will have a snowball

effect – I have another insurance group that is looking into covering

these as well.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box

7275

Woodland

Park,

CO 80863

From:

[mailto: ]

On Behalf Of Brock DO

Sent: Tuesday, December 19, 2006

8:58 AM

To:

Subject: RE:

virtual office visits

Right, and that presents a question: is

Dr. Eads the only one Kaiser has agreed to pay for these or is it their new

blanket policy? That is a lot for a phone visit! What parameters

constitute a “visit” and how is that different from a “non-visit”

phone call (ie, refill request, discuss lab result, etc). What is an

“alternative medical visit” exactly?

Re:

virtual office visits

Bravo! Beware as the news becomes public in your community. My

friend Rushika in Boston caught a lot of flak from local hospitals, staff and

colleagues for getting " paid extra " for services a lot of other docs

feel like they provide (becasue they do it once in a great while whereas you do

it all day long everyday). I am very happy for you. It is well deserved.

Bob

Eads

<michelle.eadsworldnet (DOT) att.net> wrote:

Yippee!!

It’s official – Kaiser of Colorado

Springs has agreed to reimburse me $50 for each phone visit and virtual office

visit (email) done by their members starting 1/1/2007. Kaiser has been

paying for my $60 annual fee/person (which will be gone as of 2007) and $20 for

each virtual office visit. At least one insurer is paying for alternative

medical visits.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland

Park,

CO 80863

__________________________________________________

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This is just the very beginning of extending the office visit beyond

the usual 15-30 minute visits. If what we desire is " a continuous

healing relationship " , then this is the way to go. Compensation for

this type of relationship I believe is also the way to go. As has

been mentioned, when you have been with a number of patients for 10

or 15 years, this type of care becomes easier and is much

appreciated. As family physicians, we must think outside the " office

box " . In my opinion, this is the way we will not be replaced by

minute clinics.

Lou Spikol

Louis Spikol M.D.

Senior Healthcare Information Technology Consultant

Center for Health Information Technology

American Academy of Family Physicians

lspikol@...

lspikol@...

mobile:

>

> Yippee!!

>

> It's official - Kaiser of Colorado Springs has agreed to reimburse

me $50

> for each phone visit and virtual office visit (email) done by their

members

> starting 1/1/2007. Kaiser has been paying for my $60 annual

fee/person

> (which will be gone as of 2007) and $20 for each virtual office

visit. At

> least one insurer is paying for alternative medical visits.

>

> A. Eads, M.D.

>

> Pinnacle Family Medicine, PLLC

>

> phone fax

>

> P.O. Box 7275

>

> Woodland Park, CO 80863

>

> __________________________________________________

>

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