Medical, Ethical and Legal Considerations
This is the fourth and final post addressing teleheath. By now, we know that it is a growing practice area for many health care professionals. And that telenutrition is one of the health care areas that lends itself well to utilizing technology to provide Medical Nutrition Therapy (MNT) to a variety of clients in a variety of different settings.
Along with all the benefits, there are some down sides to consider as well. First, telenutrition services may allow less personal contact. You may not get the non-verbal physical cues and there is the absence of eye contact during phone calls or audio conferences. This may be particularly important with clients with eating disorders.
Reimbursement is another area to consider if patients are not paying out of pocket. Medicare is Federal and provides the same reimbursement throughout the country, but third party payers can vary greatly with regard to their guidelines and reimbursement. Prior to providing telehealth services, RDs should check their payer contracts and client’s individual health plan benefits for Current Procedural Terminology (CPT) codes and coverage parameters. CPT codes that are recognized for telehealth may vary from CPT codes used for traditional services. More information related to this can be found on the Eatright.org website under Telehealth Policy, Regulation and Payment for Nutritionists. Eatright.org offers a webinar on telehealth, too.
There are some practical considerations to ponder as well: who will you get your referrals from? how will you market yourself? who will organize your appointments and manage paperwork/bookkeeping? and how will you manage developing education materials? Will you be able to provide services in more than one language? It is also important to have liability insurance.
The future of Telehealth is evolving nationally and internationally and it will be important to ensure that client needs are met and that medical, legal and ethical issues are evaluated along the way.
Julia Thorsen, MS RD CDE CSO is a Registered Dietitian at Inova Fairfax Hospital. She also works as a Consultant Dietitian for long term care and rehab facilities in Maryland/ Virginia and is a speaker for Life With Cancer Oncology Nutrition Programs.
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