Telemedicine and Portal PolicyMichelle Turbide, LICSW
Due to a growing demand on client schedules and the challenges of residing in a rural state, I have opted to begin some telemedicine sessions on an as needed basis with current clients in September of 2018.
If you are interested in Telemedicine sessions please request to talk with me to determine if this might be a good option for you. Ultimately, it will need to be a service that will meet your clinical needs and goals.
Current trends/research suggest that telemedicine is as effective as in person, however whenever possible my preference to work with clients during in-person sessions.
Most insurances are now covering this service, but we will have to determine if your insurance requires anything specific for the service to be covered.
I have opted to work with Jituzu.com as a way of streamlining, convenience, and assisting you in a HIPAA approved encrypted client portal. Through this portal I can schedule our sessions as a telemedicine appointment and we can engage in live video/ audio conferencing on a HIPAA compliant connection.
This service is voluntary and you may opt out at any time. Please make sure you have read my practice policies and procedures which can be found on my website. They are updated on the regular so please keep up to date.
What you will need and directions for how to connect to Telemedicine sessions:
- A private place in order to teleconference with me.(I cannot be responsible for anything that is heard on your end. Please have a private room/space available for sessions where you feel safe, private, comfortable, and secure.)
- High speed internet or reliable cell service.
- A working web camera and microphone.
- Familiarity with the Jituzu app or web site in order to navigate to connect at the time of our appointment. Please check to make sure your camera, microphone, and internet browser works properly before we begin sessions.
- If you have not signed up for Jituzu let me know and I will send you an invitation. You will receive this through text and/or email. Once you receive the invite follow the link to sign up and select a user name and password.
- I cannot log into your side of the portal. If you loose/forget your username or password, I believe there is a recovery option. However, if you can’t log in please notify me. I can disconnect you form the portal and you can sign up again (but you will need to select a different user name and password.)
- You can either down load the app for your mobile device (android, tablet or iphone) or you can log in with an internet browser on a computer. (The computer must have a functioning web camera and microphone to work for telemedicine.)
- Video conferencing does not work with the Safari web browser, but does work with Chrome and firefox. It may also work with other browsers. You will have to determine if your browser will support this connection. Please make sure that this works before any scheduled sessions.
- In the portal, in the left menu, you can click on ‘videoconferencing checklist’ to verify that your audio and video are connected.
- I am only licensed in the state of Vermont. You will need to be physically in the state in order for me to provide services. I cannot meet with you via video conference if either of us are on vacation or traveling out of state.
- A few minutes before the beginning of the session log into Jituzu.
- In the app you will see an appointment under the calendar section with the video symbol (green). click on this and it will begin to connect you to the session. If it’s the first tele-session, You may need to approve that the app can use your camera and microphone. Click yes After this you will have to click on“connect” in order to join the session.
- If. you are using a web browser on your computer, click on the “appointments or video conferences” button on the left menu bar. Under scheduled appointments, you see the current scheduled appointment click on the video symbol to begin connecting to the session.
- If you have trouble connecting it is best to ‘reboot’ by exiting the app/website and attempting to connect again.
- Please email me through Jituzu or regular email if you are having troubles connecting and we will try to problem solve together.
- If I am not connected, please wait until I join. I should never be more than 5 minutes later than the scheduled time. If I am please check your messages and email in case there is an issue on my end.
- Once we are both connected, we proceed with your 45-60 minutes session as scheduled as per usual in-person therapy.
Portal and Telemedicine Guidelines and Policies
Here are my guidelines around telemedicine and use of the portal (which includes but is not limited to the following). By using the telemedicine service and portal you are agreeing to these terms.
All policies for telemedicine sessions are the same as in-person session policies. This includes my cancelation policy, billing, and clinical guidelines. Please review them if you are unsure or have questions please ask for clarification. Insurance is billed in the same manner with the same deductible, copay, or coinsurance required.
As a reminder, my policy is 24-hours of notice of cancelation. This is within a 24 hour work day. Cancelations for Monday should notify me by Friday. If you cannot make your tele-session please contact me in advance to reschedule.
- If you can’t make it to the session, it’s best to check with me to see if there is any flexibility. At times, I am able to be flexible depending on my schedule with other clients. But it is not guaranteed.
- My rates for missed sessions are $30 for a first missed session, $60 for subsequent missed session, and the usual and customary rate for more than 3 missed sessions (This rate depends on your insurance but is often up to $85-100+).
- I will give you a warning with two missed sessions. If you have more than 3 missed sessions, we will have a conversation about continuation of services.
- My preference is for 48-hours of notice so that I may best accommodate schedules for other clients. I appreciate if clients can give me as much notice as possible, and I thank you in advance for this consideration.
If you do not show for a telesession I will wait 15 minutes. If you have not contacted me or connected, I will assume that you have missed the session. All policies around billing and charges will be the same as in-person sessions.
If you are having difficulty connecting, please contact me through the portal r via email as I will not be answering my phone during tele sessions. Again, please check your connections prior to the time of appointment so that you do not miss session time.
This portal is an encrypted site, which means that information on the server is safeguarded against outside breaches. However, as you know there are no 100% guarantees with any technology. If you use the portal on your computer or an app on your phone please take precaution. Use a password that only you know and cannot be detected, close the applications after use, and take every precaution not to expose any of your protected health information (PMI). Telehealth may also have connectivity issues, buffering, and lags. please understand that is the nature of this service.
Under no circumstances can you record or capture our video sessions (audio or video). This is a breach of your private health care records. If I find that you are are recording any sessions, it could lead to an immediate termination of services.
Neither I nor Jituzu are responsible for any breaches that occur on your end. So please take precaution and read my policies and Jituzu’s policies thoroughly when you click that you agree as you sign up. Always make sure you are comfortable with the use of this technology before you use it.
Portals are for scheduling, video conferences, and messaging only. It does not grant you or anyone else access to your file, client notes, or insurance information. Those files are held on my HIPAA approved encrypted account through MyClientsPlus. I am the only accessor of those records as I am a sole practitioner and not a group practice.
Messaging through the portal carries the same policies I have regarding email so please read that section on my website or the copy I give when you began services. I am happy to provide another copy if you have lost it. While the Portal is more secure than regular email as it is encrypted, there are still risks of breach of PMI, particularly if you have a breach on your end.
You may email clinical information, upload files, and relay sensitive information about your PMI through the portal. However, this is up to your discretion, comfort level, and knowledge that nothing is ever 100% secure due to user error.
I will always ask your permission before I send any uploads to you through messaging.
If you decide to forward/relay any information from the portal outside of the Portal, I am not responsible for breaches of PMI in those cases. Again, please play it safe, ask questions, and do not use electronic communication if you are concerned.
Messaging is not for emergencies and is not a replacement for in person or video sessions. Messaging, just like email, is open to interpretation, subjectivity, and miscommunication. Messages should continue to be for scheduling, quick questions, relaying information, and some clarifications. It is not meant to be an ongoing clinical conversation. If I find that messaging is posing an issue or a concern, we will discuss the use of this service and determine what is most clinically appropriate for our therapeutic relationship.
All tele-session are scheduled in advance. Any emergencies should follow my clinal protocol of contacting me through the pager system. Please review my policy on emergencies.
I do my best to answer questions in a timely response, however I cannot always do so promptly. Please allow 48-72 hours for responses or longer if I am away. I may determine that your question or message is best suited to discuss in session and will let you know if that is my opinion. If you have any questions about this or concerns arise on either side, we will discuss it at your next session in person.
Statements and bills can be paid via the portal. If you are using an HSA card or credit card this is my preferred ways of payment.
I reserve the right to terminate your use of the portal if the policies are not followed and/or the use of the portal poses a concern on either end. If this occurs I will notify you by phone, mail, or in person regarding my determination. If I assess that telesessions are not meeting your clinal needs and goals I will discuss this with you and may terminate this service with you.
I can be contacted during working hours at 802.654.7607 ext 6 or messaging through the portal and/or regular email. I look forward to our work together,
Michelle Turbide, LICSW