Introduction to Telehealth

Anthem Blue Cross is the only private health plan in California to develop, manage, and comprehensively support a statewide Telehealth Program to improve access to care. The program began in 1998 with the first of 10 grants from the Managed Risk Medical Insurance Board (MRMIB). It was developed to:

• Increase access to care in rural areas
• Improve timeliness of diagnosis and treatment planning
• Improve quality of care

For a complete list of important contacts, go to Chapter 2 of the Telehealth Provider Operations Manual at tm-pom.pdf

Bringing Specialty Care Closer to Patients

Telehealth is a unique health care delivery method designed to examine, diagnose, treat, and educate patients at remote locations by using:

• High-speed telecommunications systems
• Computer technology
• Specialized medical cameras

For example, through a telehealth encounter, a patient in the Sierra Mountains of California may receive medical treatment from a provider or Specialist in Los Angeles or San Francisco without spending the time or money to travel to those locations.

Two Technologies Available

• Live Video (synchronized) Consult: Connects the patient, primary care physician (PCP), and Specialist in real time via videoconferencing equipment to discuss the patient’s medical condition.
• Store and Forward (asynchronous) Consult: Uses software to store and encrypt the pertinent medical data and images. The secured data is then transmitted electronically to the Specialist for review and consult.

Positive Patient Experience

Telehealth improves the patient's experience because:

• The patient can continue to be cared for by their local providers.
• The patient does not need to travel outside of their community.
• The PCP receives all records and test results from the encounter.
• The PCP consults with the Specialist participating in the telehealth encounter and works with the Specialist to design any necessary course of treatment.

Providing Reimbursement

To support the long-term sustainability of the Telehealth Network, Anthem Blue Cross:

• Provides comprehensive reimbursement for telehealth encounters for Anthem Blue Cross members enrolled in the following:
• Medi-Cal Managed Care Program
• Healthy Families Program
• County Medical Services Program (CMSP)
• California Public Employees' Retirement System (CalPERS) Basic Plan
• Butte Schools Self-funded Program Plans
• California's Valued Trust (CVT)
• Self Insured Schools of California (SISC)
• University of California (UC)
• Offers a discount program for the per minute charges associated with the high-speed telephone lines needed to complete the consult.

To inquire if you are eligible for telehealth reimbursement, please contact the Telehealth Department at  1-866-855-2271.

Beyond Clinical Use

To date, the Anthem Blue Cross Telehealth Network has reported more than 45,000 clinical encounters and more than 7,000 non-clinical consults such as community services, continuing medical education, and other training sessions.