But, CMS does not want to reimburse a physician every time he/she sends an email...so what justifies an online or email physician visit...a lot of gray area here yet to be established and will it ever be adequately established?  Also, with all the information available on the web today via "Dr. Google" and other avenues, will patients even use the online consultation instead of doing a web search?  The web is free and there will be a charge for online virtual visits with the physician...so the question is will this encourage better health care?  In the past, when calling your physician for help, unless it is a very simple refill routine or follow up questions on labs, etc. most physicians ask that you make an appointment and come in.  Some things still need to be seen first hand before an adequate diagnosis can be made..or you may end up with a "virtual diagnosis"...BD 

The doctor doesn't have to see you now. Thanks to new technology, patients may not always need a face-to-face visit with their doctor to get the care they need. And thanks to a growing awareness of this fact on the part of health plans, structured, Internet-facilitated and reimbursable "virtual visits" are on the verge of entering mainstream medicine. Virtual visits also are seen as a tool that will save money, provide convenient care and maybe do something to solve the problem of patients not having access to their doctors.

Eads is also the sole practitioner in a pilot study Kaiser Permanente of Colorado Springs is conducting exploring the use of virtual visits by in-network independent physicians. She receives $50 for an online consultation and said preliminary figures from 2006 show that Kaiser is saving between $70 and $120 on each virtual visit.

These arrangements began about five years ago, first with Blue Cross of Massachusetts and Blue Shield of California and have grown to include Aetna, Cigna HealthCare and WellPoint Blues affiliates. Tarkoff said RelayHealth-facilitated reimbursement programs were developed in Florida, Kansas City, Mo., and the New York City tri-state area, and are now being established in Illinois, New Jersey and Ohio.

But Medicare reimbursement is not imminent. "I don't want to reimburse a physician every time he sends an e-mail," said Kerry Weems, acting administrator for the CMS. While not opposed to reimbursing physicians for electronic care as part of an overall reimbursement package, per-e-mail reimbursement is something Weems currently opposes. Physicians might get "very adept" at e-mailing, Weems said.

Modern Healthcare Online

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