Virtual Visit (Telemedicine)

Background

Many physicians, including us, knew that there would be a future expansion of telemedicine and video medical visits. It was just unclear how it should and would be best used and how extensive a part of medical care it would become. Well, leave it to a pandemic to quickly force our hand and lead us to start doing it extensively.

We personally feel that it can never entirely replace being in the same room as a patient for many situations. A virtual visit is clearly not as ideal as a traditional in-person visit with a new patient and yet during a virtual visit the doctor and patient can see each other’s faces as opposed to seeing a masked face when being seen during a pandemic. And if a new patient needs to have a cardiac evaluation by a cardiologist and an in-person visit is not possible or practical, then a virtual visit certainly is better than nothing.

The technology available that make video visits possible has turned out to be critically important to allow us to stay connected to patients and provide care as best as possible given trying circumstances. Once the pandemic is behind us (which might be longer than we hope), there is no doubt that telemedicine will remain a significant part of how we care for patients.

Even for an established patient, pandemic related restrictions aside, perhaps a virtual visit is most useful when it is a supplemental or complementary additional option when the patient and physician have a long-standing, trusting and comfortable relationship. In the right circumstance, it might even provide additional value on top of regular in-person medical appointments. But just as phone calls, emails or texts have advantages and disadvantages when communicating, a video visit carries benefits but potential missing pieces in trying to deliver the best medical care.

How Can I Arrange A Virtual Visit?

Immediately after the stay-at-home orders during the COVID-19 crisis, our office immediately ramped up our ability to provide a virtual visit in lieu of cancelling an in-office doctor’s appointment or having a patient not being able to see the doctor due to the stay-at-home restrictions. We still are offering this option (when felt to be appropriate by our doctors) to all of our regular patients.

Our office will schedule your visit for a set date and time that works for you and the doctor. Prior to your virtual visit with Dr. Urman or Dr. Caren, one of our staff members will call you (either via Face Time, Zoom or on the phone) to take all pertinent visit information, such as medications, blood pressure/pulse reading, temperature and any complaints or reason for the virtual visit that need to be documented.  This is similar to when you come to our office and one of our medical assistants (Nancy, Erika or Kahlia) bring you back to an exam room. They will also make sure that the video connection on your end is working.

So it is important to make sure you have an up-to-date and accurate list of all your medications and dosages prior to the virtual visit just like when you come to our office. If you have a blood pressure monitor at home, please record it with your pulse / heart rate prior to your visit so that we can document that information.  If you feel like you might have an infection, please take your temperature as well and provide that for us as well.

Once all the intake information is entered by our staff and we have verified there are no technological glitches with your device or the connection, the doctor will either join the same Face Time or Zoom session or will Face Time you back to continue your virtual visit.

What “equipment” does a patient need?

A smartphone, tablet, laptop or desktop with a camera. Specifically either:

  • an Apple device with a camera and speakers (iPhone, iPad, iMac or MacBook) capable of using Face Time (this has thus far turned out to be the most popular option for our patients)
  • a PC, laptop, phone or tablet that is set up for Zoom conferencing, or
  • a smart phone that can receive a link providing a HIPPA secure video interface through Doximity

If you have Kardia or an Apple watch you may use these for an EKG recording at home prior to seeing the doctor and email it to [email protected] prior to your appointment time (Premier and Concierge patients can email directly to the doctor if they prefer). 

It is helpful to be able to take a blood pressure on yourself as well. Click here to see which home blood pressure monitor devices have been validated for clinical accuracy as determined through an independent review process.

Are These Virtual Visits Covered By Insurance?

Given the emergency declarations from the White House and Congress, these virtual telemedicine visits are covered by Medicare (at least temporarily until the coronavirus state of emergency is over) and will be billed by our office on behalf of Medicare patients similar to regular visits in our office.  

For patients with private insurance, similar to when services are rendered in-person here in the office, payment will be due by credit card at the time of the visit. Our staff will be happy to review charges with you but they will be comparable to in-office visits based on time involved (including documentation by the doctor that occurs prior to or after your “face time” with them) and complexity of the medical issues and visit. We can bill your insurance as a courtesy however, we do not know how much of (or if) the telemedicine visit cost will be covered. Most private insurance companies have been covering these services, especially since the coronavirus pandemic but sometimes deductibles might apply. You can check with your insurance carrier for more information. As we are able, we will try to help you find this out but encourage you to stay connected with your cardiologist, leveraging technologies available.

We hope that by offering Telehealth services, we will help you stay safe and healthy and relieve any worries you may have.  Feel free to let us know if you have any questions.  Also, please bear with us if there are any hiccups, please understand this is all new for all of us and there will be a learning curve for this process.  

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Los Angeles, CA