Private Payers Telemedicine Programs
Program Name: Alaska Federal Health Care Access Network
Program Contact: Linda Lekness, Director
Address: 4201 Tudor Center Drive, Anchorage, AK 99508:
Telephone: (907) 729-2261
Fax: (907) 729-2269
Email: lmlekness@afhcan.org
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? joint initiative of all federal partners in AK
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: May 2002, Blue Cross of AK announced that they would most likely pay if billed.
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Arizona Telemedicine Program
Program Contact: Gail Barker
Address: PO Box 245105, Tuscon, AZ 85724
Telephone: (520) 626-7330
Fax: (520) 626-1983
Email: barkerg@email.arizona.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? Yes
Video? Yes
Private Payer ID? 0
Facility Fee? No, because billing process is too labor intensive
Actions that Led to Reimbursement: In October 1998 the Arizona Telemedicine Program sent out correspondence to private payers in AZ notifying them that they would be billing for TM services in January 1999, and did they want a modifier. They did not indicate if services were store and forward or real time. Hewever, their Medicaid program specifically approved both SF and RT in their telemedicine notification to the FI's.
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Avera McKennan Hospital and University Health Center
Program Contact: Mary DeVvany
Address: 800 E. 21st St., Sioux Falls, State SD 57117:
Telephone: (605) 322-6038
Fax: (605) 322-6006
Email: mary.devany@mckennan.org
Academic Program? No
Non Profit? Yes
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Submission of claim
Modifiers Eligible Presenters: GT
Other Procedures or Requirements: N/A
Program Name: Blue Cross of CA- Wellpoint Health Networks
Program Contact: Bridget Hogan Cole
Address: 5151 A Camino Ruiz, Camarillo, State CA 93012:
Telephone: (805)384-3533
Fax: (805)482-5368
Email: bridget.cole@wellpoint.com
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: N/A
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Central Texas Telehealth Network
Program Contact: Llinda Wolf
Address: N/A, N/A, State TX 0:
Telephone: (254)724-1068
Fax: N/A
Email: N/A
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: N/A
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Childrens Hospital Los Angeles
Program Contact: Chris Baker, RN, MSN-Administrator
Address: 4650 Sunset Blvd. Mailstop 12, Los Angeles, State CA 90027:
Telephone: (323) 669-5408
Fax: (323) 671-3877
Email: cbaker@chla.usc.edu
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? Unsuccessful
Actions that Led to Reimbursement: N/A
Modifiers Eligible Presenters: TM
Other Procedures or Requirements: N/A
Program Name: Community Memorial Hospital, Inc.
Program Contact: Traci Albers or Tina Dummer
Address: 8th and Jackson, PO Box 319, Burke, State SD 57523:
Telephone: (605) 775-2621
Fax: (605) 775-2754
Email: alberst@siouxvalley.org or dummert@siouxvalley.org
Academic Program? No
Non Profit? Yes
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? $20, HCPCS code Q3014
Actions that Led to Reimbursement: Sent UB92 claim and received payment.
Modifiers Eligible Presenters: Eligible Presenters: midlevel nurse
Other Procedures or Requirements: N/A
Program Name: East Carolina University Telemedicine Center
Program Contact: Gloria Jones or David Balch
Address: Brody School of Medicine 600 Moye Blvd. Brody Bldg, Greenville, State NC 27834:
Telephone: (252) 816- 3855
Fax: (252) 816-1872
Email: jonesgl@mail.ecu.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: sent letter of announcement to private payers
Modifiers Eligible Presenters: TM modifier used internal purposes, RN's are eligible
Other Procedures or Requirements: N/A
Program Name: Eastern Montana Telemedicine Network
Program Contact: Thelma McClosky Armstrong
Address: 2800 10th Ave. North, Billings, State MT 59107:
Telephone: (406) 657-4057
Fax: (406)657-4875
Email: tmcclosky@emtn.org
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: letter to BCBS requesting coverage, after feasibilty study by BCBS reimbursement was established. After BCBS approval, letters to all other payers was sent , no turndowns and no special conditions
Modifiers Eligible Presenters: TM modifier
Other Procedures or Requirements: N/A
Program Name: Eddy Visiting Nurse Association
Program Contact: Mary Beth Rutkowski
Address: 433 Riner St., Troy, State NY 12180:
Telephone: (518) 274-6200
Fax: (518) 274-2908
Email: rutkowskim@nehealth.com
Academic Program? No
Non Profit? Yes
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? yes
Actions that Led to Reimbursement: Two month free trial of telehome care visits
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Fairview University Health Services
Program Contact: Zoi Hills
Address: 2450 Riverside Ave., Minneapolis, State MN 55454:
Telephone: (612) 672-2980
Fax: (612) 672-7050
Email: Zhills1@fairview.org
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? $20- $91.50, code Q3014
Actions that Led to Reimbursement: Met with some private payers and just submitted claims to others.
Modifiers Eligible Presenters: GT
Other Procedures or Requirements: N/A
Program Name: Inland Lorthwest Health Services
Program Contact: nancy Vorhees
Address: PO Box 469, Spokane, State WA 99202:
Telephone: (509) 232-8104
Fax: (509) 232-8358
Email: vorheen@inhs.org
Academic Program? No
Non Profit? Yes
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Prior autherization.
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Integris Health
Program Contact: N/A
Address: N/A, N/A, State OK 0:
Telephone: N/A
Fax: N/A
Email: N/A
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: N/A
Modifiers Eligible Presenters: TM
Other Procedures or Requirements: Presenter at remote site reimbursed 50%, No Store and Forward except Radiology reimbursed
Program Name: Kansas University Telemedicine Services
Program Contact: David Cook
Address: 3901 Rainbow Blvd. 2012 Wahl Annex, Kansas City, State KS 66160:
Telephone: (913) 588-2251
Fax: (913) 588-2227
Email: dcook@kumc.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: approached BCBS after Medicaid agreed to reimburse for TM services, they agreed to follow medicaid Plan
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Kentucky TeleCare
Program Contact: Rob Sprang
Address: K117 KY Clinic, 740 S. Limestone, Lexington, State KY 40536:
Telephone: (859) 257-6404
Fax: (859) 257-2881
Email: rsprang@pop.uky.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: State legislation- KRS 11.550.
Modifiers Eligible Presenters: GT, all presenters eligible
Other Procedures or Requirements: N/A
Program Name: LeBonheur Children's Medical Center
Program Contact: N/A
Address: N/A, N/A, State TN 0:
Telephone: N/A
Fax: N/A
Email: N/A
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Letters and phone calls to payers stating they would begin billing
Modifiers Eligible Presenters: TM
Other Procedures or Requirements: Store and Forward restricted
Program Name: Maine Telehealth Network
Program Contact: Ronald Emerson
Address: RR2 Box 380, Lubec, State ME 4652:
Telephone: (207) 733-5541
Fax: (207) 733-2847
Email: N/A
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: letter sent to Anthem BCBS that described Medicaid's willingness to reimburse for TM and stated that MTN would begin billing for TM. No response from BCBS and no claims ever denied
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Marshfield Clinic Telehealth Network
Program Contact: Nina Antonetti, RN, MBA, PhD
Address: 1000 N. Oak Ave., Marshfield, State WI 54449:
Telephone: (715) 389-3694
Fax: (715) 387-5733
Email: antonion@mfldclin.edu
Academic Program? No
Non Profit? Yes
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? $20 Medicare, $35 to all others (coded as "other")
Actions that Led to Reimbursement: Told private payers they were going to bill them and they paid.
Modifiers Eligible Presenters: GT modifier added to all claims
Other Procedures or Requirements: Regulatory rules for stae medical assistance does not provide payment for care via TH.
Program Name: Mid Nebraska Telemedicine Network
Program Contact: Wanda Kjar-Weekley
Address: N/A, N/A, State NE 0:
Telephone: (308) 865-2718
Fax: (308) 865-2986
Email: wandakjar@chi-midwest.org
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: BCBS willing to reimburse after seeing BCBS Kansas model. No letters sent to others payers, just billed as traditional encounter
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: "Telemedicine" noted in remarks section of claim form
Program Name: Missouri Telehealth Network
Program Contact: Joe Tracy
Address: 2402 Lemone Industrial Blvd., DC345.00, Columbia, State MO 65212:
Telephone: (573) 884-7958
Fax: (573) 882-5666
Email: tracyj@health.missouri.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Contacted private payers by letter and/or phone.
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: all clinical encounters have "Telemedicine" in notes section of form
Program Name: Mountaineer Doctor Television
Program Contact: Christopher Budig
Address: N/A, N/A, State WV 0:
Telephone: (304)293-6945
Fax: N/A
Email: N/A
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: N/A
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Oroville Hospital
Program Contact: Joyce White, RN
Address: 2767 Olive Way ste. B, Oroville, State CA 95966:
Telephone: (530) 532-8271
Fax: (530) 532-8290
Email: jwhite@orohosp.com
Academic Program? No
Non Profit? Yes
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: California Telemedicine Development Act of 1996.
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Plumas District Hospital
Program Contact: Michael Le Brook
Address: 1065 Bucks Lake Rd., Quincy, State CA 95971:
Telephone: (530) 283-7133
Fax: (530) 283-3541
Email: michael_lebrook@pdh.org
Academic Program? No
Non Profit? Yes
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 1
Facility Fee? Integrated with office visit charge
Actions that Led to Reimbursement: mailed assumptive letters to payers, stating billing would begin using standard forms and CPT codes unless a letter of denial or request for special processing was received. No letters received
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: facility fee integrated with office visit charge
Program Name: Southeast Telehealth Partners
Program Contact: N/A
Address: N/A, N/A, State GA 0:
Telephone: N/A
Fax: N/A
Email: N/A
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Sent letters to BCBS, just billed other payers
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: St. Vincent Healthcare
Program Contact: Cindy K. Leenknecht, RN, MS, CS
Address: PO Box 35200, Billings, State MT 0:
Telephone: (406) 237-4520
Fax: (406) 237-4493
Email: cindy.leenknecht@svh-mt.org
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? 20
Actions that Led to Reimbursement: Submitted letter of intent to top private payers.
Modifiers Eligible Presenters: GT
Other Procedures or Requirements: N/A
Program Name: Telecare Network at St. Alexius Primecare
Program Contact: Anjyl Babeck
Address: 900 East Broadway Box 5510, Bismark, State MD 58506:
Telephone: (701) 530-7797
Fax: (701) 530-7099
Email: ababeck@primecare.org
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: BCBS initially rejected requests in 1996 and 1997, but has been reimbursing all TM services since 1998
Modifiers Eligible Presenters: TM modifier
Other Procedures or Requirements: N/A
Program Name: Texas Tech University Health Sciences Center Dept. of Internal Medicine
Program Contact: Cathy Ehrenfeld
Address: 3223 South Loop Rm. 4B236 TTUHSC, Lubbock, State TX 79423:
Telephone: (806) 743-3179
Fax: N/A
Email: N/A
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Contractual agreement.
Modifiers Eligible Presenters: GT
Other Procedures or Requirements: Authorization required
Program Name: UC Davis Center for Health and Technology
Program Contact: Jana Katz
Address: 2315 Stockton Blvd., Sacramento, State CA 95817:
Telephone: (916) 734-1361
Fax: (916) 734-1366
Email: jana.katz.bell@ucdmc.ucdavis.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? Yes
Video? Yes
Private Payer ID? 0
Facility Fee? yes
Actions that Led to Reimbursement: SB 1665 in 1997
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: University of Arkansas Medical Sciences
Program Contact: Nevada Copeland or Ann Bynum
Address: 1123 S. University Ste. 400, Little Rock, State AR 72204:
Telephone: (501) 686-2792
Fax: (501) 686-2774
Email: copelandnevada@uams.edu or bynumcarola@uams.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? Yes
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Letters to payers stating that billing would begin using standard forms and CPT codes unless letter of refusal or request for special processing was received. No letters were received.
Modifiers Eligible Presenters: Uses "01" at end of CPT codes for internal tracking
Other Procedures or Requirements: N/A
Program Name: University of Tennessee Telehealth Network
Program Contact: Mary Anders
Address: 1924 Alcoa Highway Box 70, Knoxville, State TN 37920:
Telephone: (865) 544-9338
Fax: (865) 544-9338
Email: manders@mc.utmck.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Representative contaced private payers and discussed benefits.
Modifiers Eligible Presenters: Telemedicine
Other Procedures or Requirements: N/A
Program Name: University of Texas Medical Branch, Center for Telehealth and Distance Education
Program Contact: Jeanette C. Hartshorn, RN, PhD, FAAN
Address: 301 University Blvd., Galveston, State TX 77555:
Telephone: (409) 747-6290
Fax: (409) 747-6249
Email: N/A
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? Yes
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: N/A
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: University of Virginia
Program Contact: Ms. Carolyn Craig
Address: PO Box 800707, Chalottesville, State VA 22908:
Telephone: (434) 924-5470
Fax: (434) 924-5747
Email: cac3v@virginia.edu
Academic Program? Yes
Non Profit? Yes
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: Emergency consultation claim submitted and paid after the fact.
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: N/A
Program Name: Upper Peninsula Telehealth/Marquette Ggeneral Program
Program Contact: Susan Makela
Address: 580 W. College Avenue, Marquette, State MI 49855:
Telephone: (906) 225-4766
Fax: (207) 225-7696
Email: smakela@mgh.org
Academic Program? No
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? No
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: letters sent to al payers to intro duce them to TM, at least 2 inquiries have resulted
Modifiers Eligible Presenters: N/A
Other Procedures or Requirements: phone calls to pre-authorize all clinical encounters, "Telemedicine" written in remarks section of claim form
Program Name: Virginia Commonwealth University Health System
Program Contact: Debbie justis, RN, MSHA
Address: PO Box 980531, Richmond, State VA 23298:
Telephone: (804) 828-6114
Fax: (804) 628-3932
Email: sebastiandb@vcu.edu
Academic Program? Yes
Non Profit? No
Private Company? No
Managed Care? No
Federal Agency Civilian? No
Federal Agency Military? No
State Agency? No
Other? N/A
Store and Forward? No
Video? Yes
Private Payer ID? 0
Facility Fee? N/A
Actions that Led to Reimbursement: N/A
Modifiers Eligible Presenters: Eligible presenters: prison staff
Other Procedures or Requirements: N/A