Telehealth provider?
Protect your practice

Yes, telehealth is covered subject to terms and conditions. The Policy covers telehealth where you and the patient are located in Australia. Cover can apply where you are outside of Australia for less than 120 days, or the patient is outside of Australia for less than 90 days, but only where there is a pre-existing clinical relationship.

See our  Indemnity Insurance Policy for terms and conditions.

If your practice is outside of the terms of the Policy, you can complete a Practice Assessment Questionnaire for individual assessment to request telehealth to be agreed in writing by MIPS.

You should be aware of, and be familiar with the following requirements when considering participating in telehealth services:

• You must have appropriate recognised registration, qualifications, training and experience for the health services you provide.
• You are expected to consult and practice in accordance with Ahpra codes and guidelines
• You are required to consult and practice in accordance with your relevant collegiate guidelines and standards.
• You are expected to consult and practice in accordance with the current Medicare Guidelines and standards in respect of telehealth consultations.

Video conferencing is strongly preferred as this is likely to provide a more comprehensive consult and improved quality of care to your patient.

The decision to conduct a phone or video consultation is at your discretion but depends on a variety of issues such as the purpose of the consult, the patient having compatible technology and ability to deal with a remote consult.

Some conditions and consultations are not appropriate for telehealth. Telehealth must only be offered if measures are in place for patients to have a face-to-face consultation when this is clinically necessary.

You are encouraged to exercise your clinical judgement to assess the risks of not conducting face-to-face consultations in the following instances:

• patients with high-risk potentially serious conditions who are unable to self-monitor appropriately
• when a physical/direct examination is pivotal to support clinical decision making
• when a patient’s ability to communicate effectively over the phone or through video is compromised and there is unavailability of a support person
• circumstances where there is doubt about the appropriateness of a phone or video consultation.

In a telehealth consultation, the healthcare service is located in the country of the patient NOT the practitioner. Your membership benefits (including insurance cover) will not extend to any claim for or arising out of or in connection with the provision of healthcare outside of Australia or its Territories unless covered in the policy or agreed in writing by MIPS.

Cover for telehealth can apply for temporary periods where you have a pre-existing patient relationship and either you are outside of Australia for less than 120 days or the patient was outside of Australia for less than 90 days. See Indemnity Insurance Policy.

If you are not located in Australia when providing telehealth services to a patient located in Australia, you should submit information in writing to MIPS for assessment and clarification.

You cannot bill services to Medicare for telehealth provided to patients outside of Australia, even if the patient would normally be an eligible patient in Australia Medicare covers services provided only in Australia. It does not refund treatment or evacuation expenses overseas.

The risks of complaints, claims, investigation and reputational risks are always present. Medico-legal risks may arise from failure to diagnose, late diagnosis or misdiagnosis, inadequate reassurance about symptoms, or failure to follow up or to properly refer to another practitioner.

These risks are increased due to the inability to perform a hands-on assessment and examination.

You can reduce the patient risk and medico-legal risk by:

• obtaining and documenting valid consent to treatment
• maintaining accurate and updated records
• ensuring optimal quality of technology equipment
• ensuring optimal storage of images.
• ensuring continuity of care

Risks associated with telehealth services can be minimized by having prior knowledge of the patient’s history and access to updated and detailed records. Ideally, there should exist a previous relationship between the patient and healthcare professional and/or clinical practice offering the service. However, this is not an essential requirement.

MIPS recommends you seek professional technology assistance if you’re not confident you can undertake telehealth securely.

No specific equipment or software is required to deliver telehealth services. There are several platforms designed for Australian health care practitioners. Freely available video calling apps and software are acceptable. However, non-commercial versions of these may not meet applicable laws for security and privacy. Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws.

You should follow a similar approach to face-to-face consultations. That is:

• Maintain updated and written health records
• Get verbal informed consent from the patient to proceed with a telehealth consultation and keep a record of this consent
• Record the details of any other persons present during the telehealth consultation.
• Record whether the consultation was via telephone or video conferencing.
• Document any clinical finding and follow-up if needed.
• Document any technical issues during the telehealth consultation that may have compromised the quality or safety of this service.