TELEMEDICINE
INSTRUCTIONS FOR A TELEMEDICINE VISIT
If you wish to take advantage of the "Telemedicine" visit, you must have a "smart phone or computer with web access”. We are using the service "doxy.me" so as to have a secure/encrypted HIPAA compliant "Telemedicine" visit.
You must call the office to schedule a "Telemedicine" visit just as you would schedule a normal office appointment. You can not spontaneously initiate an unscheduled "Telemedicine" visit.
Near the time of your appointment you will receive a text message or email to initiate the "Telemedicine" visit:
-Click on the link to go to the site.
-Enter your name.
-Check the "I agree to the Terms of Service" box
(You can read them by tapping "Terms of Service" or reading them below).
-Click "Check in".
-Click "enable camera".
On the day of the "Telemedicine" visit please to do the following & record the results prior to the visit:
-Take your blood pressure
-Record your pulse (this is usually provided by your blood pressure machine)
-Weigh yourself first thing in the morning
-Please have your medicine list available for review
TELEMEDICINE: What to Expect
What is Telemedicine?
Telemedicine is the exchange of medical information from one site to another via electronic communications. The telemedicine service offered to you will allow you to have a medical appointment with Dr. Mezei via secure and interactive video equipment. You will be able to speak in real-time with Dr. Mezei during your telemedicine appointment.
Is Telemedicine Safe?
Yes, all telemedicine sessions are safe, secure, encrypted, and follow the same privacy (i.e., HIPAA) guidelines as traditional, in-person medical appointments. Your telemedicine appointments will always be kept confidential. In addition, telemedicine appointments are NEVER audio or video recorded without the patient’s consent.
Can I Choose Not to Participate?
Of course, with this program you have been offered the option of seeing Dr. Mezei via secure and interactive video equipment within. It is your choice to participate.
Things to Remember about Your Telemedicine Appointment:
-You will schedule your telemedicine appointments in the same way you currently schedule an office appointment with Dr. Mezei by calling 314-486-1396.
-As with your traditional, in-person medical appointments it is your responsibility to call Dr. Mezei at 314-485-3500 to cancel an appointment if you are unable to attend your telemedicine appointment. Cancellations should be made at least 24 hours prior to the appointment time.
-The telemedicine program has a no-show policy. You will be discharged from the telemedicine program if you no-show for 3 consecutive telemedicine appointments, without prior contact to the scheduling staff at healthcare organization. To prevent this from happening, always call 314-485-3500 if you cannot make your appointment.
-On the day of your appointment you will check-in through the ‘telemedicine invitation’ as you would for a traditional, in-person medical appointment.
-If you have any questions before or after the session, you may call the office at 314-485-3500.
-If you miss a telemedicine appointment and need a prescription refill or you have any questions about your medication, you must contact the office directly at 314-485-3500. Please be sure to call at least 72 hours prior to running out of medication.
Telemedicine is the exchange of medical information from one site to another via electronic communications. The telemedicine service offered to you will allow you to have a medical appointment with Dr. Mezei via secure and interactive video equipment. You will be able to speak in real-time with Dr. Mezei during your telemedicine appointment.
Is Telemedicine Safe?
Yes, all telemedicine sessions are safe, secure, encrypted, and follow the same privacy (i.e., HIPAA) guidelines as traditional, in-person medical appointments. Your telemedicine appointments will always be kept confidential. In addition, telemedicine appointments are NEVER audio or video recorded without the patient’s consent.
Can I Choose Not to Participate?
Of course, with this program you have been offered the option of seeing Dr. Mezei via secure and interactive video equipment within. It is your choice to participate.
Things to Remember about Your Telemedicine Appointment:
-You will schedule your telemedicine appointments in the same way you currently schedule an office appointment with Dr. Mezei by calling 314-486-1396.
-As with your traditional, in-person medical appointments it is your responsibility to call Dr. Mezei at 314-485-3500 to cancel an appointment if you are unable to attend your telemedicine appointment. Cancellations should be made at least 24 hours prior to the appointment time.
-The telemedicine program has a no-show policy. You will be discharged from the telemedicine program if you no-show for 3 consecutive telemedicine appointments, without prior contact to the scheduling staff at healthcare organization. To prevent this from happening, always call 314-485-3500 if you cannot make your appointment.
-On the day of your appointment you will check-in through the ‘telemedicine invitation’ as you would for a traditional, in-person medical appointment.
-If you have any questions before or after the session, you may call the office at 314-485-3500.
-If you miss a telemedicine appointment and need a prescription refill or you have any questions about your medication, you must contact the office directly at 314-485-3500. Please be sure to call at least 72 hours prior to running out of medication.
TELEMEDICINE CONSENT FORM
1. I authorize Dr. Leslie E. Mezei/Premier Heart Group to allow me/the patient to participate in a telemedicine (videoconferencing) service with "doxy.me".
2. The type of service to be provided by via telemedicine is: CARDIOVASCULAR DISEASE.
3. I understand that this service is not the same as a direct patient/healthcare provider visit, because I/the patient will not be in the same room as the healthcare provider performing the service.
4. Dr. Mezei has made available to me the nature and purpose of the videoconferencing technology and has also informed me of expected risks, benefits and complications (from known and unknown causes), attendant discomforts and risks that may arise during the telemedicine session, as well as possible alternatives to the proposed sessions, including visits with a physician in-person. The attendant risks of not using telemedicine sessions have also been discussed. I have been given an opportunity to ask questions, and all my questions have been answered fully and satisfactorily.
5. I understand that there are potential risks to the use of this technology, including but not limited to interruptions, unauthorized access by third parties, and technical difficulties. I am aware that either Dr. Mezei or I can discontinue the telemedicine service if we believe that the videoconferencing connections are not adequate for the situation.
6. I understand that the telemedicine session will not be audio or video recorded at any time.
7. I agree to permit my/the patient’s healthcare information to be shared with other individuals for scheduling and billing. I agree to permit individuals other than my/the patient’s healthcare provider and the remote healthcare provider to be present during my/the patient’s telemedicine service to operate the video equipment, if necessary. I further understand that I will be informed of their presence during the telemedicine services. I acknowledge that if safety concerns mandate additional persons to be present, then my or guardian permission may not be needed.
8. I acknowledge that I have the right to request the following:
Omission of specific details of my/the patient’s medical history/physical examination that are personally sensitive, asking non-medical personnel to leave the telemedicine room at any time if not mandated for safety concerns or
termination of the service at any time.
9. It is the responsibility of the telemedicine provider to conclude the service upon termination of the videoconference connection.
10. I/the patient understand(s) that my/the patient’s insurance will be billed by the local healthcare provider and the telemedicine healthcare provider for telemedicine services. I/the patient understand(s) that if my insurance does not cover telemedicine services I/the patient will be billed directly by both the local healthcare provider and the telemedicine healthcare provider for the provision of telemedicine services.
11. My/the patient’s consent to participate in this telemedicine service shall remain in effect for the duration of the specific service identified above, or until I revoke my consent in writing.
12. I/the patient agree that there have been no guarantees or assurances made about the results of this service.
13. I/the patient acknowledge the telemedicine program’s no-show policy which states that I/the patient will be discharged from the telemedicine program if I/the patient no-show for three consecutive telemedicine appointments, without prior contact to the scheduling staff at spoke site.
14. I confirm that I have read and fully understand both the above and the Telemedicine: What to Expect form below or downloaded.
2. The type of service to be provided by via telemedicine is: CARDIOVASCULAR DISEASE.
3. I understand that this service is not the same as a direct patient/healthcare provider visit, because I/the patient will not be in the same room as the healthcare provider performing the service.
4. Dr. Mezei has made available to me the nature and purpose of the videoconferencing technology and has also informed me of expected risks, benefits and complications (from known and unknown causes), attendant discomforts and risks that may arise during the telemedicine session, as well as possible alternatives to the proposed sessions, including visits with a physician in-person. The attendant risks of not using telemedicine sessions have also been discussed. I have been given an opportunity to ask questions, and all my questions have been answered fully and satisfactorily.
5. I understand that there are potential risks to the use of this technology, including but not limited to interruptions, unauthorized access by third parties, and technical difficulties. I am aware that either Dr. Mezei or I can discontinue the telemedicine service if we believe that the videoconferencing connections are not adequate for the situation.
6. I understand that the telemedicine session will not be audio or video recorded at any time.
7. I agree to permit my/the patient’s healthcare information to be shared with other individuals for scheduling and billing. I agree to permit individuals other than my/the patient’s healthcare provider and the remote healthcare provider to be present during my/the patient’s telemedicine service to operate the video equipment, if necessary. I further understand that I will be informed of their presence during the telemedicine services. I acknowledge that if safety concerns mandate additional persons to be present, then my or guardian permission may not be needed.
8. I acknowledge that I have the right to request the following:
Omission of specific details of my/the patient’s medical history/physical examination that are personally sensitive, asking non-medical personnel to leave the telemedicine room at any time if not mandated for safety concerns or
termination of the service at any time.
9. It is the responsibility of the telemedicine provider to conclude the service upon termination of the videoconference connection.
10. I/the patient understand(s) that my/the patient’s insurance will be billed by the local healthcare provider and the telemedicine healthcare provider for telemedicine services. I/the patient understand(s) that if my insurance does not cover telemedicine services I/the patient will be billed directly by both the local healthcare provider and the telemedicine healthcare provider for the provision of telemedicine services.
11. My/the patient’s consent to participate in this telemedicine service shall remain in effect for the duration of the specific service identified above, or until I revoke my consent in writing.
12. I/the patient agree that there have been no guarantees or assurances made about the results of this service.
13. I/the patient acknowledge the telemedicine program’s no-show policy which states that I/the patient will be discharged from the telemedicine program if I/the patient no-show for three consecutive telemedicine appointments, without prior contact to the scheduling staff at spoke site.
14. I confirm that I have read and fully understand both the above and the Telemedicine: What to Expect form below or downloaded.