Upmc Telehealth Copay



What is Telehealth?

Telehealth is a more encompassing term and includes telemedicine. Telehealth is the use of technology to deliver health care, health information, and health education at a distance. Examples of telehealth in action include:

  • Forwarding test results to another facility for diagnosis
  • Continuing professional education, including video presentations by specialists to general practitioners
  • Remote monitoring to supplement home visits from professional nurses

1, 2021, most benefit plans include telehealth visits with in-network providers. Members are responsible for any copay, coinsurance or deductible, according to their benefit plan. Details are in the updated telehealth/telemedicine reimbursement policy. UPMC Health Plan is committed to your health. Check out our tips to stay healthy, and find out which services can help if you're experiencing COVID-19 symptoms.

Telehealth at UPMC

Telehealth is transforming the future of health care by changing the way patients and their families interact with their physicians and health care systems.

UPMC's Telehealth Program continues to experience extraordinary growth, supporting your goals of providing patients with:

  • Better health care
  • Improved health outcomes
  • Decreased costs

Our telehealth program provides subspecialty clinical services in 35 areas. Telehealth consultations give remote patient access to specialized care where it otherwise would not be available.

Through our pioneering telehealth research and a passionate and persistent commitment to developing new models of care delivery, UPMC has seen a double-digit increase in completed telemedicine visits and expanded patient access to world-class clinical care.

What is Telemedicine?

Telemedicine seeks to improve patients’ health regardless of where they live by providing specialist services remotely. It gives patients and physicians access to clinical services at a distance through interactive telecommunications. Physicians and patients have real-time two-way communications via audio and video equipment. This enables them, at a minimum, the ability to evaluate, diagnose, monitor, consult, treat, and educate patients remotely with the referral and/or participation of their local physicians. Telemedicine increases patients’ accessibility to specialist services and saves patients the time, cost, and inconvenience of travel.

Telemedicine at UPMC

UPMC Telemedicine offers your patients easier access to specialized clinical care. Telemedicine is a true innovation in improving access to those who need services most, and optimizes treatment for those in need of acute care. Telemedicine users say they see no difference in quality between a telemedicine appointment and an in-person visit.

Telehealth

By offering telemedicine visits in strategic locations — some of which are on or near our UPMC campuses — we can provide convenient access to pre- and post-visit tests, labs, and radiology imaging. Maintaining these services within the UPMC health system helps to support improved patient compliance and allows better care coordination.

Features of telemedicine:

  • HIPAA-compliant, synchronous audio and video-enabled equipment
  • HIPAA-compliant store-and-forward technology
  • Remote patient monitoring
  • Nursing triage support
  • MyUPMC, a secure patient portal
  • UPMC AnywhereCare, 24/7 access to UPMC clinicians for on-demand low acuity conditions

What is a Teleconsult Center?

UPMC Teleconsult Centers are dedicated outpatient, multispecialty clinics located in more rural areas throughout western Pennsylvania. At these centers, patients can have virtual appointments with UPMC’s world-class physicians via live, synchronous audio- and video-enabled, HIPAA-secure technology.

Who benefits from telehealth?

Both patients and health care providers can benefit greatly from telehealth. Telehealth provides access to care for patients regardless of their location. Providers are able to more efficiently expand access to their patients.

Patients benefit from UPMC's Telehealth Program with:

  • Timely treatment close to home
  • Reduced travel time and cost
  • Access to world-class treatment
  • Improved quality of care

Physicians and other providers benefit from:

  • Efficient expansion of their clinical practices
  • Opportunities to consult with other specialists
  • Better care coordination

What equipment is needed for telehealth?

Telehealth needs vary depending on the type of care being provided.

  • Synchronous, HIPAA compliant video conferencing using secure high-speed internet via a personal computer, tablet, smartphone, or other similar device
  • Asynchronous store-and-forward HIPAA-compliant technology facilitates image transfers to support clinical diagnosis and treatment plans
  • Remote monitoring via asynchronous, HIPAA-compliant clinical protocols and video conferencing that incorporates Bluetooth-enabled peripheral devices, and secure high-speed data transfer via a personal computer, tablet, smartphone, or other similar device

In addition to the core equipment, there are a number of peripheral devices that can be incorporated as part of a telehealth visit. These devices include:

  • Digital stethoscope
  • Digital otoscope
  • Digital ophthalmoscope
  • Total exam camera
  • Digital scale
  • Digital blood pressure cuff

Upmc Waiving Copays

What is the UPMC remote monitoring program?

Upmc Telehealth Modifier

UPMC provides in-home telehealth equipment to promote proactive patient self-care for chronic conditions, such as heart failure and diabetes. This equipment is used to monitor patients' key measures and provide patients with easy access to guidance about their health issues. Since nurses cannot be in a patient's home 24 hours per day, telehealth remote monitoring provides significant benefits for patients, their families, and their physicians, including:

  • An extra layer of security
  • Reduced readmissions and costs
  • Compliance and continuity of care
  • Convenience and increased independence

Is telehealth reimbursed?

Telehealth reimbursement varies depending on payor. Many private and government payors are expanding telehealth coverage. Patients will need to check with their insurance providers regarding their specific coverage benefits. Some additional resources can be found by calling 1-800-533-UPMC (8762).

We continue to advocate for coverage of this service. Watch for our list of insurers and plans as they continue to grow.

For more information on UPMC telehealth coverage for your specific plan or information on plan reimbursement, contact your insurance company.

Contact Us

Telehealth IT Support: 1-855-483-5633

UPMC AnywhereCare
For questions or help, including billing questions about UPMC AnywhereCare, call our technical support line at 1-866-884-8579 or email us at help@myupmc.com.