Telehealth Audit and Medical Dictation Reminders

Applies to both BCBSND Commercial and BCBSND Medicaid Expansion lines of business
 
As part of the Provider Audit Work Plan, Blue Cross Blue Shield of North Dakota (BCBSND) is informing providers the Special Investigation Unit (SIU) and Provider Audit department is auditing telehealth services during the third quarter. We are reminding providers who perform telehealth services the following information is a requirement in their patient’s medical record when these services are provided. Review our Telehealth Services Reimbursement Policy.

• Documentation supporting medical necessity and appropriateness for the health service visit.
• Location of the individual and location of the provider.
• Mode of telehealth services provided, such as asynchronous (store-and-forward), synchronous (real time).
• If synchronous telehealth was provided the provider must identify the originating facility name (the site that facilitated the telehealth service).
• If digital online synchronous telehealth was provided the provider must specify that the visit was a digital online visit. 

BCBSND requires the locations of the patient and provider during the telehealth service to be recorded in the documentation. To ensure provider safety, should the provider be working from their home office, BCBSND does not require the provider’s home address to be included in the patient’s medical record, though a notation is required to verify the place where the service was performed.
 
For additional questions refer to our BCBSND Customer Contact Center at 1-800-368-2312 or BCBSND Medicaid Expansion Customer Contact Center at 1-833-777-5779.