A New Dimension for Telehealth > E-Commerce​

Telemedicine has been with us for sixty years.(1) The Covid-19 pandemic of 2020 has brought this capability to the forefront as it is now an accepted component for the delivery of healthcare expertise.

Would You Recommend the TeleDentists to a Friend or Family Member?​

Howard Reis, CEO, The TeleDentists The TeleDentists stepped up during the Coronavirus pandemic providing an important service during a time of critical patient need.  Dental offices closed, but patients continued to get toothaches. Patients found relief by looking for solutions on the Internet or were guided to our site by two major insurance companies, Cigna and Anthem. For most patients, this was their first experience with teledentistry, in fact it was their first experience with telehealth of any kind.  We had promised our partners that we would be able to see patients in 10 minutes or less and we met that metric 99% of the time.  But we also wanted to make sure our patients were satisfied with the experience.  So, we asked them. Net Promoter Score (NPS) is a management tool that can be used to gauge the loyalty of a firm's by asking a single question.  According to the June/July 2020 issue of Fortune Magazine, it is a tool which is used by 2/3 of the Fortune 1000 companies.  But it can be easily used by small companies such as ours.  The question we asked, “Would you refer a friend or family member to The TeleDentist service?”Patients were asked to rate us from 0 (not very likely) to 10 (very likely).  Results can range from -100 to +100. Our results were “off the charts” positive as we scored an 82. Companies are usually compared to others in their field, and below is a chart of average NPS by industry with a range of 27 to 71.   This article from 2017 says that the average NPS for dental providers is “1”. https://www.dentistryiq.com/practice-management/patient-relationships/article/16365771/survey-says-dental-patients-are-dissatisfied-solving-the-patient-experience-problem This article says that Teledoc has an average NPS of “9” and that we even beat the very highest ranked companies, Costco and Starbucks. https://customer.guru/net-promoter-score/teladoc-inc Many companies, when reviewing the results of their first NPS survey are in a position off asking themselves, “How can we do better?”.  We, the TeleDentists are in the fortunate position of asking, “How do we keep doing what we’re doing?”.  We are very conscious of the fact that the results are largely a factor of the ability of a qualified dentist to provide expert relief at the time of patient need.  Delivering a service which is valued by its customers is one way that a small company becomes a larger one.​

2500 Reasons to Use TeleDentistry​

The Coronavirus crisis has been a defining event for the telehealth industry, and teledentistry is no exception. The TeleDentists had the team and infrastructure in place to respond to the tremendous spike in demand.  During the recent lockdown, relief has been provided to well over 2500 patients, each of whom had their own reason to seek teledentistry support. We asked our TeleDentists for some patient experiences to share. Here are some of their most memorable moments with The TeleDentists: Dr. L: Diagnosing a mucous cyst, also known as a mucocele on a nine-year-old boy.Dr. B: Mom in China with a 2-year-old...that was a cool one...2 year old child fell and broke a tooth... gave some guidance half a world away. Sr. S: I had a memorable patient who was experiencing coronavirus symptoms: dry coughing, fever, breathing difficulty, chills and loss of taste and smell and was waiting to get the test results. At the same time all this was happening, the patient woke up with a swelling in the face from a tooth problem.  The patient was in a lot of pain and very concerned about being not allowed to go to the dentist or even to the ER... the patient didn't know what to do... Until the patient found The Teledentists. After reviewing the medical history and current symptoms, I prescribed a non-Azithromycin antibiotic, just in case the patient may need it later along with pain meds. It was confirmed someone else could pick up the medications since the patient was not allowed to leave home unless severe Covid-19 symptoms were occurring. Patient Testimonial: I was starting to feel slight tooth pain in the middle of the COVID-19 pandemic. Due to lockdown restrictions, dentist would only see emergency cases, which I did not qualify for. However, as the pain started to increase, I got increasingly worried and didn't know who to turn to get it checked out. A friend told me about The TeleDentist, and I immediately gave it a try. Within minutes, I could set up a video appointment with a knowledgeable dentist who took the time to understand my problem. He was very aware of the contact restrictions and suggested that my pain most likely comes from a widened gap between two teeth, between which food gets caught, a topic which I could safely deal with after the restrictions are lifted. This feedback gave me a great peace of mind I don't know I could have found anywhere else! What are the demographics of our patients? Geography: The states with the largest number of exams were California, New York and Florida, with patients coming from 49 states (plus Puerto Rico). On a per capita basis, the most active state is New Jersey.  We suspect that we would have seen more patients from Texas, except for the fact that Texas is the ONLY state where dentists are not allowed to practice teledentistry. Age: We always suspected that millennials would be the age group most attracted to teledentistry and the data bears this out as 48.8 % of our patients were born between 1980 and 1994,  The youngest patient was two years old and the oldest patient was 96! 57% of patients have been female. What are the reasons for a TeleDental consult? Out of the thousands of consults performed, the most common is a general complaint of “Pain” (40%). Following closely is the concern of “broken teeth” (33%). Lastly, “swelling” (10%) and “abscesses” (10%) are common conditions.  The TeleDentists does receive the occasional call for help with TMJ or pediatric issues.  The future As we return for the office, there will be plenty of reasons for continuing to use teledentistry.  For the dentist to screen their patients and prioritize the most important cases.  For the patient to meet their dentist face-to-face rather than seeing them for the first time behind a mask.  More and more, teledentistry becomes part of the new normal practice of dentistry.​Article by Howard Reis, CEO, The TeleDentists

The TeleDentists: Teledentistry Option During Coronavirus​

Tags: Dental Marketing, Front Office Team, DSO Series, Practice Leadership, Billing & Coding, Coronavirus, COVID-19 Teledentistry is quickly becoming a popular option for dentists seeking to stay open and see emergency dental patients during the coronavirus outbreak. The TeleDentists service was founded by Maria Kunstadter, DDS. It offers dentists a HIPAA-compliant teledentistry method to (1) stay connected with their current patients of record and (2) connect with new patients seeking a dentist.In this video, Dr. Kunstadter talks with Patient Prism CEO Amol Nirgudkar and nationally-known dental insurance expert Teresa Duncan about how it provides revenue for dentists during the coronavirus pandemic. How The TeleDentists Service Works Dentists can visit TheTeleDentists.com website  for an overview. In a nutshell, dentists who sign up for The TeleDentists receive a custom website link (URL) that they can put on their website and share via email or text message with their current patients.  That allows current patients of record to schedule an online consultation with their own dentist through The TeleDentists service. Dentists can also connect with new patients via The TeleDentists service. Dentists can sign up to provide online consultations. When a new patient completes the online medical history form, The TeleDentists will connect the patient with a dentist who’s available to perform the 10-minute video consult. The dentist then determines if the patient needs to see a dentist for urgent care, can postpone treatment, or can go to the local pharmacy to purchase a temporary solution. Dentists can perform virtual dental consultations for patients both in their geographic area and outside of it. Dentists can also sign up with The TeleDentists to have emergency dental patients forwarded to their practice. Another dentist may be the one that performs the remote dental consultation and recommends the patient get seen quickly, and then The TeleDentists receptionist will provide the patient with the contact information for a dentist in the patient’s zip code / geographic area. The virtual consultations can take place from the dentist’s home or office. What Can Dentists Do Via Teledentistry?  The number one reason patients like teledentistry is because it lets them know if the dental problem they are experiencing is serious. Many teledentistry calls are about toothaches, pain, swelling, cracked teeth, chipped teeth, loose teeth, abscesses, cold sores, filling fell out, temporary crown came off, broken denture, etc. Parents often use teledentistry to ask questions about their children’s teeth and whether something is normal. Current patients of record who use clear aligners like teledentistry because the general dentist or orthodontist can determine whether the patient is ready for his or her next set of aligners and simply mail them out. Teledentistry eliminates the need for unnecessary exposure during this coronavirus outbreak, while still providing dental expertise. And it gives dentists a way to stay in touch with their current patients during this challenging time. It also gives the dentist the opportunity to triage dental emergency calls and determine how many members of the dental team will be needed to treat the patient in-office. How Do Dentists Bill for Teledentistry? The TeleDentists is HIPAA-compliant and includes the protocols needed to gather the patient’s data so it can be submitted to insurance companies for reimbursement. “Many of the carriers have relaxed their in-person requirement for the limited evaluation,” said Teresa Duncan, author of Moving Your Patients to Yes: Easy Insurance Conversations. “This is an unprecedented situation and carriers are being more flexible. There is a cost involved with being a teledentist and that’s why we have 9995 and 9996 codes as descriptors.  So you charge for the limited exam, and then add the descriptor code,“ she explained. The D9995 code is for synchronous teledentistry consultations, which means that the consult happened in real-time, and the D9996 code for asynchronous consultations, which is when the dentist is assessing the patient based on information that has been collected and forwarded to the dentist for review. Read the ADA's Teledentistry Guidance The TeleDentists collect a payment from the patient at the time of service for the consultation, which is typically $69 but has been decreased to $49 to increase access to care during the coronavirus shutdown. Contact The TeleDentists for more information on revenue collection.Teledentistry after Coronavirus “At the end of the day, you want to provide dental care,” said Dr. Kunstadter. “By staying in close contact with your patients and helping them when they really need it, you’ll be on a good footing when you reopen. You’ll be able to schedule those people and say let’s get that filling fixed now.” Plus, keeping patients in the dental office and not in the emergency room is vital right now. Typically, people spent $1.7 billion in emergency room treatment for dental problems. “Who would want to go into the emergency room with a toothache and come out with a virus?” asked Dr. Kundstadter. “It’s critical that we help them get the care they need. They should be calling a dentist.” Telemedicine has been around for more than two decades. Now teledentistry is catching up. “A new study shows 78% of people would like to have teledentistry as an option, and that was before coronavirus hit,” said Dr. Kundstadter. There will be even more demand now. Resources To learn more about The TeleDentists, visit thedeledentists.com/dentists. To reach Teresa Duncan, listen to her podcasts, or order her must-have book "Moving Your Patients to Yes: Easy Insurance Conversations," please visit OdysseyMgmt.com. For more videos with industry leaders and downloadable guides, visit PatientPrism.com/Guides.​

How Teledentistry Has Changed – In the Past 30 Days​

What has changed for teledentistry since the onset of Covid 19?  In a word, everything. For Patients Patients can no longer visit their dentists as most offices have closed or are only seeing emergency patients.  Patients can no longer go the Emergency Room for dental pain as they are standing on long lines or getting turns away.  Patients are still getting toothaches.  Many are finding The TeleDentists at www.theteledentists.com where they can see a dentist, usually within 10 minutes, who can remediate the problem, get a prescription sent to a local pharmacy, and get information about local dentists whose offices are open for emergencies.  For Dentists Many have closed their offices in compliance with the American Dental Association recommendation that dentists nationwide postpone elective procedures in response to the spread of the coronavirus disease.See: https://www.ada.org/en/publications/ada-news/2020-archive/march/ada-recommending-dentists-postpone-elective-procedures Dozens of dentists have found The TeleDentists to be able to remotely provide service to their own patients, or patients of The TeleDentists. For The Telehealth Industry Established telehealth/ telemedicine providers have seen a substantial increase in patient volume especially as President Trump and Vice President Pence have extolled the benefits of telemedicine in their daily briefings and announced relaxed regulation and expanded Medicare benefits. https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak https://mhealthintelligence.com/news/feds-ok-interstate-licensing-paving-way-for-telehealth-expansion  Among the new policies, the CMS Fact Sheet listed these key takeaways:For the duration of the emergency, Medicare will pay for telehealth services furnished to beneficiaries “in all areas of the country in all settings” at the same rate of as regular, in-person visits.HHS will not conduct audits to track whether there was a prior patient-physician relationship for claims submitted during the public health emergency.Patients must initiate services, but physicians may inform their patients on the availability of telehealth services. In addition,States are allowing license flexibilityThe general policy regarding medical licensure and telehealth is that the physician must be licensed in the state where the patient is located at the time of treatment. The AMA telehealth guide notes that CMS has waived this requirement for Medicare patients and that states may request a waiver for Medicaid patients. “Discretion” on HIPAA rulesThe OCR, the HIPAA-enforcement arm of the HHS, announced that it will exercise “enforcement discretion” and would not impose penalties for noncompliance with regulatory requirements during the “good faith provision of telehealth” services during the COVID-19 national public health emergency.Prescribing of Controlled SubstancesThe Drug Enforcement Agency (DEA) published a COVID-19 Information Page on the Diversion Control Division website, providing guidance relating to the COVID-19 public health emergency, including the ability to prescribe controlled substances via telemedicine without a prior in-person exam.Some Telehealth companies have been forced to let patients know to expect delays.  This notice was found on the web site of a major provider: We are experiencing longer than normal wait times due to the COVID-19 pandemic. For The TeleDentists Significantly increased patient volumes, hundreds of interested dentists, new business opportunities, very little sleep. We have signed agreements with two multi-state DSOs (dental service organizations) and will be implementing service for their dentists and patients this week.  We are also in discussion with several major insurance companies who want to provide relief for their patients during the crisis.  Our dentists have stepped up significantly.  Our partners have been understanding.  Our technology vendor has been able to handle the increase in volume. Is this the turning point we hoped for which will put teledentistry on the map? We at The TeleDentists are amazed and humbled by the response from healthcare workers and support staff around the country and are hoping to do our part.  We pray that readers of this blog and their families are healthy and safe.  We’re all in this together. Howard Reis, CEO, The TeleDentists​