American Well, other providers to be reimbursed for online health care

As announced in the October Record, Blue Cross Blue Shield of Michigan and Blue Care Network have contracted with American Well^®, a best-in-class telehealth company, to provide online doctor visits to our members using the award-winning Amwell™ online health care technology.

The company will provide HIPAA-compliant, 24/7 online health care to Blue Cross and BCN members of self-funded groups that have opted to receive this benefit, effective Jan. 1, 2016.

BCN fully insured individual and group members will also have this benefit, effective Jan. 1, and Blue Cross will expand its offerings to include fully insured individual and group members, effective July 1, 2016. Note: This option is not available to Medicare or Medicaid members at this time.

As you know, we encourage members to coordinate their health care through their primary care doctors. However, when a primary care doctor isn’t available, this service offers members the ability to connect with a doctor by online video 24 hours a day, seven days a week for common illnesses.

Members with this benefit can talk to one of American Well’s extensive practice group of U.S. board certified doctors from their laptop, tablet or smartphone. Members will be encouraged to follow up with their primary care doctor and will have the option to send a report about the online consultation to their doctor.

What about doctors not affiliated with American Well?

Blue Cross Blue Shield of Michigan

All Blue Cross providers credentialed to perform evaluation and management services can be reimbursed for HIPAA-compliant online services for members of any self-funded group that opts in as of January 2016. After July 1, the code will be reimbursable to Blue Cross providers for all insured individual and group members.

As more details become available, we’ll share them in future issues of The Record.

Blue Care Network

For BCN, some special guidelines apply:

• Only primary care physicians can participate.
• Online visits can be conducted with established patients only.
• Special software must be used to structure an automated clinical encounter. Online visits are not covered for BCN Advantage^SM members.
• For Healthy Blue Living^SM HMO members, online visits cannot be used for the initial visit required to complete the Blue Care Network Qualification Form, but can be used for other visits, as appropriate.
• For online visits, all physician consultative services must be documented in the member’s medical record. BCN reserves the right to audit these records and confirm billing integrity and accuracy. Online visits are subject to retrospective review.

For more information and billing guidance related to BCN participating providers, refer to the Claims section of the BCN Provider Manual.