Telehealth services offer safe alternative solutions for providing care and access to your patients in a time when they need it the most. Learn about getting started telehealth services and tips on making the most out of your telehealth experience. E2E Medical Billing Services would like to extend a special thanks to Pamela Suraci for taking the time to discuss this important topic. Pamela Suraci, MA, LMFT, CIRT is a certified telemental health provider with an office in San Luis Obispo, California.
“This is a chance for us as therapists to really make our voices heard. We’re going to be an important part of this process, and I think we’re going to see telehealth really move forward from here on out.”
Our intension is to learn from Pamela Suraci that how even the smallest of details can elevate your clients’ experience. She started using telehealth so she could travel and still meet with clients. Thanks to her extensive experience providing virtual therapy services to her clients, she’s an excellent resource for those who’re beginning to use telehealth or telemental health services for the first time. This interview has been edited for clarity.
Starting Telehealth Services
Why is telehealth important?
This is a chance for us as therapists to really make our voices heard. We’re going to be an important part of this process, and I think we’re going to see telehealth really move forward from here on out. It’s in our best interest to get very good with telehealth because this is forcing people to see doctors, therapists, and lawyers like this. People are going to get really cool with it really quick—and we need to keep up.
How should I get started and test my telehealth services set-up?
It’s always a good idea to try it out with a friend. You can create a dummy account in your practice management software, send it to a friend, have them sign in as a client, and then get their feedback. “Does this sound better or does this sound better?” Try it with headphones and without headphones. A lot of people aren’t quite sure where to look, so you can talk to your friend online and say, ”Okay, so does it look like I’m looking at you now?”
What equipment do I need for telehealth serivces?
I don’t use headphones often. I can do it with or without. Sometimes, if it’s just going to be a short period of time, I go ahead and do it just for sound quality. I also have an external camera. Then, I have a ring light because the lighting is hard to adjust. Like today, it’s kind of foggy and rainy outside, so it wouldn’t give me enough light by my window. You can crank it up or down and it can be different colors. I think the headphones, the camera, and the ring light altogether were less than $100. They’re not expensive and they really do enhance the experience, so I think that’s really important. If we’re fuzzy and grainy, it’s not going to be a good experience for our clients.
Is there anything different about telehealth sessions?
One of the things that you have to remember is that if you’re working with telehealth, you tend to sit really, really still. When we’re with other people, we don’t realize it, but we have lots of little micro-movements. On telehealth, you’re sitting really still, so you want to make sure that you give yourself at least 15 to 30 minutes in between sessions so you can get up, move around, get a drink of water, stretch, do whatever you need to do to move yourself. If you move in between sessions, set yourself up so you can see your client’s face. And make sure you’re taking good care of yourself just like you have to do when you’re at your office. That way you won’t find it super exhausting. It’s a new thing, so cut yourself some slack.
How do you collect informed consent forms for telehealth services?
I do all of the informed consent work online. They fill all that out there. I have them sign a document, which makes clients acknowledge and agree to my fees and that I don’t take insurance. I think the online intake process is really helpful for clients—and super helpful for me. Then, when they come in for their intake, it’s all about them. It’s not about confidentiality laws. Make sure they understand everything, but that takes five to 10 minutes instead of 20 to 30 minutes. Then, we get to really focus on why they’re there, which is what they want to be there for.
How do you help clients maintain their privacy during telehealth sessions?
Whenever I start a telehealth session, the first question is always, “Where are you?” and then, “Do you have privacy?” That’s the thing that I also want to emphasize. When clients come to my office, I am in charge of their privacy. With telehealth, they’re in charge of their own privacy—but it’s still on us to make sure they know that. If, for example, they say, “I’m at home,” you have to say to remind them, ”Are you home alone? Will you be interrupted?” That is just one of the things about telehealth. It’s not a downfall. It’s just a thing we need to remember. We need to find out where they are.
Sometimes, clients go out to their car to do it, because that’s sort of their mobile office. ”Where are you parked?” “I’m parked at _____.” We should know where they are, so that’s always the first thing in my notes: client privacy verified and client location, and then where they’re going to go after. Like, “Okay, tell me what are you going to do after our telehealth session.” Just so I know that they’re going to take care of themselves. I note that, too.
How do you collect client intake forms when using telehealth services?
I do take new clients virtually. The way I do it is, unless it’s a direct referral from a physician that I’ve worked with before or a client that I’ve worked with, I’ll usually do a 15-minute free video consultation. That gives them a chance to meet me (sort of) and to try out the telehealth platform and I’ll make sure that this seems like the right fit. If it’s not the right fit, then I’ll direct them to a different directory or to somebody I know in their area.
Then, I send all the intake documents off to them through SimplePractice and they fill all those out. Then, when they come in—and when I say come in, they’re either coming into my physical office or they’re coming into my virtual office—I say, “Thank you so much for filling all this out, this really saves us a lot of time so we can get down to business. But I do have a couple questions.” And I can go through all of their intake information before they come in, which gives me an opportunity to get more information.
This also gives them a chance to kind of sit down and think about what they want to say and give the amount of information they want to give. It’s a little counterintuitive for a therapist, but bear with me on this. When a client comes in, they may have things they know they need to talk about but don’t. They might have shame about something that’s gone on. They should be allowed to give us the amount of information they want to give us until they get to know us and know that we’re safe. The intake is a really good way for them to do that. It’s very, very safe. And my intake is very thorough, but it really helps people kind of narrow down what they want.
One of my questions is, ”What are your goals for counseling?” That really helps them because we’re talking about when you’re done, right? We’re not talking about “What’s your problem?” We’re talking about ”What does it look like when you have what you want?” and that really helps people get very focused. So, I think that online intake is really important.
How do you bill clients and accept payments online?
I think the best practice is to keep a credit card on file. When clients do their intake, I get their credit card information and their permission to charge their card. That way, at the very end of the session, we finish up and I say, “Okay, I’ll just charge this to the card on file.” And that’s it—instead of having to spend five minutes after we’ve had this really intense personal conversation to say, ”Go get your wallet.” It is really kind of takes away from the tone of the meeting that you’ve just had. Plus, it’s just super easy at the end of the day. You can put it on AutoPay or you can just click “Pay” through all your sessions and that takes care of it.
I do have clients who prefer to pay with cash or check, and when they’re coming into the office, that’s fine. For those people, if I’ve had them as a client for a while and they really want to pay me with the check, they can just put it in the mail. But for the most part, people are paying with credit cards anyway. I feel like people are pretty used to paying for things with credit cards online now.
Worried about starting telehealth services during Coronavirus/ COVID-19 outbreak? Hopefully, this gave you the basics you need to get started. Stay connected for more articles on telehealth billing services. For any enquires on medical billing for telehealth/telehealth services, feel free to call E2E Medical Billing Services at 888-552-1290 or write to us at info@e2eMedicalBilling.com