NORTHPOINTE BEHAVIORAL HEALTHCARE SYSTEMS

POLICY TITLE: Telepsychiatry PAGE 1 of 1

MANUAL: Health Services SECTION: Health

ORIGINAL EFFECTIVE DATE: 2/15/07 BOARD APPROVAL DATE: 7/25/13

REVIEWED/REVISED ON DATE: 9/28/15 CURRENT EFFECTIVE DATE: 10/1/15

REVISIONS TO POLICY STATEMENT: YES NO OTHER REVISIONS: YES NO

APPLICATION:

NBHS providers involved in telepsychiatry and individuals who meet medical necessity.

POLICY:

Its intent is to provide easier access for service recipients to a psychiatrist/practitioner. It is expected that this benefit will be used when travel is prohibitive to the beneficiary or there is imminent health risk justifying immediate medical need for these services.

PURPOSE:

to establish procedures for providing telepsychiatry services when the psychiatric practitioner is not on site.

DEFINITIONS:

Telepsychiatry: Also known as Telemedicine and Telehealth is the use of an electronic media to link beneficiaries with health professionals in different locations. The examination of the beneficiary is performed via a real time interactive audio and video telecommunications system. This means that the beneficiary must be able to see and interact with the off-site practitioner at the time services are provided via telepsychiatry.

PROCEDURES:

1.  The treating practitioner, in conjunction with the service recipient and clinician, will determine if telemedicine is appropriate.

2.  The room and set up shall be such to provide maximum privacy.

3.  Informed Consent for Receiving Services via Video Conferencing (cl.108) will be obtained prior to the initial appointment. The individual has the right to withdraw the consent and request that appointments be made face to face.

4.  When clinically appropriate the Clinical Care Manager/Care Manager, or designated representative, will be present with the individual at the distant site to facilitate communication.

5.  Nursing supervisor (or delegate) will coordinate the schedule (near and distant site) as well as coordination of appropriate records, dictation, prescription, and clinical and support staff.

6.  Additional services provided at the originating site on the same date as the telemedicine services may be billed (MSA Bulletin).

CROSS REFERENCE:

NBHS Form Cl.108

MSA Bulletin 06-22