Medicare now provides incentives and rebates for medical practitioners to engage
with patients via video consultations in specific circumstances. Patients must be
located in rural and remote areas, or in eligible aged care facilities or Aboriginal
medical services throughout Australia. Rebates are also available for clinical services
provided by a health professional who is present with the patient during the video
consultation.
What is telehealth?
Telehealth, or 'health care at a distance', is the transmission of health information
and images via a range of telecommunication technologies. MBS rebates for telehealth
video consultations commenced in July 2011. Video consultations are an alternative
to face-to-face consultations and may be of particular benefit for patients and
practitioners located in rural and remote telehealth eligible areas.
Medicare requirements
Medicare rebates are available for video consultations where a patient consults
with a specialist in specific circumstances and if clinically appropriate. There
must be both a video and an audio link.
A specialist must be satisfied that it is clinically appropriate to provide a video
consultation to a patient. Advice from the referring practitioner may assist in
this decision and the referring practitioner and specialist should be satisfied
that adequate care can be given in the absence of an examination being performed
by a specialist. This will need to be determined on a patient-by-patient basis as
well as a specialist-by-specialist basis.
Medicare rebates for specialist consultations are available across the full range
of medical specialties. There may be a general practitioner, midwife, nurse practitioner,
Aboriginal health worker or practice nurse providing services on behalf of a general
practitioner, present to provide 'patient-end' services. The practitioner at the
patient end, if any, may conduct parts of the examination under direction from the
specialist.
General practitioners providing the patient-end services are ordinarily entitled
to a Medicare rebate. However, general practitioners who provide direct telehealth
consultations with patients cannot claim the Medicare rebate but can charge privately.
Documentation
Specialists should keep full notes of their consults with patients as though the
patient was sitting in the room with them. Practitioners at the patient-end must
keep records of the consultations that specifically document:
- that the service was performed by video conference
- the time taken to conduct the consultation
- the people who participated in the consultation.
Avant's Practitioner Indemnity Insurance Policy
Avant's Practitioner Indemnity Insurance Policy provides cover for claims made against
a practitioner by a patient or a patient's family in relation to the practitioner
providing telehealth. Telehealth is defined in the policy as "healthcare or unpaid
healthcare provided to, or in respect of, a patient who is not in the same place,
that uses any form of technology to enable it to be provided, including video-conferencing,
internet and telephone". This cover excludes claims that arise as a result
of telehealth provided to, or in respect of, a patient outside Australia or claims
that involve proceedings brought overseas. Cover is otherwise subject to the terms,
conditions and exclusions of the policy.
There are many other issues to be aware of when undertaking telehealth consultations,
including follow-up of patients, technology issues, security and privacy of information,
consent and communication. For more information on telehealth, please see the links.