1. Telemedicine 2016

2. 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.

3. 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

4. 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

5. 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

6. 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

7. 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.

8. 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

9. 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.

10. 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