Non-Epic Integrated Video VisitsHow to schedule and communicate with patientMay 5, 2020 Betsy Winga, MD

Created by Winga, B. Created 05/2/20 Revised 05/5/20 Approved by Tim Lineberry, MD

Quick Updates

New Telephone Visit Rules

• Medicare & Medicaid will now reimburse at a higher rate for telephone care – private carriers are likely to follow

• Please continue to code as you are – 99421, 99422, 99423 – based on time. Document to support.

• Coding will crosswalk on the back-end to submit properly.

Documentation needs to…

• Clearly state modality (telephone, video, etc.)

• Clearly outline medical decision making

• Clearly indicate time spent.

• Do NOT need to have start and stop times, but just total time

TO REPEAT: Do NOT change

coding practices for telephone care.

99421, 99422, 99423

GT Modifier

• Yes – repeating again because it’s so important

• GT modifier on every single video visit. Every single one. Always. Every single one.

TO REPEAT:

GT modifier on every video visit.

Now, for the feature film…

What kind of virtual visits are available to me as an

ambulatory/HOD/HB ambclinician?

Quick Care? No – that is a separate retail program

E-Visits? No – that is a separate retail program.

We are working to develop options that the general medical group will be able to use for their patients, but not available at this time.

Same Day? YES

Scheduled? YES

Epic Integrated Non-Epic Integrated

Video platform Zoom Zoom

Patient enters Through myAdvocateAurora Through Zoom

Provider enters Through the Epic visit Through Zoom

Visit type Specific ones… The appropriate, typical visit type (i.e. follow-up)

Coding Appropriate E&M with GT modifier Appropriate E&M with GT modifier

ConsentPatient will see and sign as part of check-in

Patient will not see & sign. Needs verbal consent (and documentation of such)

Check-inCompleted through myAdvocateAurora process

Not completed by patient actions. Must be completed on AAH’s side by somebody.

AVSPatient receives through myAdvocateAurora

Patient doesn’t receive unless you mail it to them

Scheduling Will eventually be able to schedule online Will not be able to schedule online

Interpreter services

Available after the provider joins (but not for the patient during the myAdvocateAurora process

Available from end-to-end of visit

Epic Integrated Non-Epic Integrated

Video platform Zoom Zoom

Patient enters Through myAdvocateAurora Through Zoom (no myAdvocateAurora required)

Provider enters Through the Epic visit Through Zoom

Visit type Specific ones… The appropriate, typical visit type (i.e. follow-up)

Coding Appropriate E&M with GT modifier Appropriate E&M with GT modifier

ConsentPatient will see and sign as part of check-in Patient will not see & sign. Needs verbal consent

(and documentation of such)

Check-inCompleted through myAdvocateAurora process

Not completed by patient actions. Must be completed on AAH’s side by somebody.

AVSPatient receives through myAdvocateAurora

Patient doesn’t receive unless you mail it to them

Scheduling Will eventually be able to schedule online Will not be able to schedule online

Interpreter services

Available after the provider joins (but not for the patient during the myAdvocateAurora process

Available from end-to-end of visit

While the Epic-Integrated video visits are preferred, we

recognize that there are occasions where the patient

cannot navigate myAdvocateAurora. Here is

an alternative.

Three Steps

1)Schedule appointment in Epic

2)Schedule appointment in Zoom

3)Text patient the information about Zoom meeting from Epic

Caveat…this is only applicable to clinics

using Epic. For those HOD and HBamb clinics still on another EMR, we

have an alternative workflow for you.

Schedule in Epic

Schedule in Epic• Use the normal visit type

• Do NOT use one of the myAdvocateAurora video visits

• In “Appt Notes” you will put Video Visit, then copy and paste the Zoom meeting information. Where do you get that? Continue on to next step.

Schedule in Zoom

Schedule in ZoomFirst, you must have a full Zoom license issued from the organization.

First, you must have permission in Zoom to schedule for the clinician that you’re scheduling for.

If you have not previously requested this, please call the help desk. They will need:

• Your work email (for Zoom license)

• Your workstation ID# (for Zoom software)

• A list of all the providers that you want to schedule for (for scheduling)

In Zoom, click “schedule”

You will be in the scheduling window

Change “Topic” to

“<Patient first name> <First letter last name> Video Visit”

Set date, time and duration

Mark the Calendar as “Other Calendars”

Click the down arrow next to “Advanced Options”

Click “schedule for” and choose the appropriate clinician.

***if you’re scheduling for yourself, leave this box unchecked***

When you click “schedule,” this window will come up.

Highlight the Meeting ID and Password, and click <Ctrl> and <c> at the same time to copy.

Leave this window open and return to Epic.

Back on the Epic Schedule…• In “appointment notes,” click in the box, right click and select paste

to insert the meeting ID and password on the next line

Epic Schedule…• The information is now stored and easily available for that

appointment

Finally, text the patient

In the search box at the upper right-hand corner of the chart, type “DAR.” ***Use your mouse to click on “Jump to DAR...”

Also access from the big “Epic” button in the top left (go to “scheduling”) and can pin it to your frequently used sites.

Can wrench it into your tool bar on the very top of the page.

***Hint: click on the magnifying glass to get the search box

***Hint: do NOT hit “enter”

On the pop-up screen, complete the following:

1) Leave “login dept” checked

2) Check “all” under Visit Type

3) Check “all” under Appointment Status

4) Include dates desired –must populate both boxes.

5) Click “Run”

Select the patient you want, and click “send update”

Enter text verbiage and click “Send.” You are limited to 140 characters.

Recommended message:Your appt is <date of appt> at <time> <AM/PM>. Join here: <insert entire hyperlink to meeting>

Example:

Your appt is 05/01/20 at 11:30 AM Join here: https://zoom.us/j/97927441816?pwd=WllRU1NjWTVoYXhkVC9wQTVIR3lEUT09

Do NOT use extra verbiage as the text is limited to 140 characters and they must have the full URL to join the meeting.

Go Back to the Zoom invite, select the hyperlink information, and click <Ctrl> and <c> at the same time to copy

Go back to Epic, create the message, and when ready for the hyperlink, right click and select “paste”

What if…..?????

You’re already in the meeting, and need to send the patient (or a colleague) the meeting ID and password so they can join?

Select “Invite” at the bottom of the window, and you can find your meeting information in the pop-up window. If you text that to the patient using our recommended workflow but substituting this information for the hyperlink, the patient can join you.

***Hint: some versions must select “manage participants” and then select “invite.” ***

***Hint: You can send an invite directly from this screen, but it will be delivered to the patient via your personal or work email.***