Insurers to pay for some online consultations
■ The initiatives launched by Aetna and Cigna will be offered in selected markets.
By Tyler Chin — Posted May 1, 2006
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Aetna Inc. and Cigna HealthCare separately announced that each will reimburse doctors in specific areas who engage in online consultations with their established patients for nonurgent problems.
Effective May 3, Aetna, of Hartford, Conn., will offer the online service to all of its fully insured members in California and Florida. Sponsors of self-insured plans can opt to offer the benefit to employees who are members of Aetna, said Charles Cutler, MD, the plan's national medical director for quality and clinical integration.
Starting in July, Broomfield, Conn.-based Cigna initially will reimburse for online consultations in California between physicians and members who are employed by Cisco Systems Inc. and Intel Corp. On Jan. 1, 2007, coverage of the online service will become available to all self-insured employers in Arizona, California, Connecticut, Florida, New Jersey and New York, said Jeffrey Kang, MD, chief medical officer of Cigna.
The specific amounts insurers will pay physicians were not immediately available at press time, but those payments will likely fall within a range of $25 to $35, said Briana Pompei, a spokeswoman for RelayHealth Corp. Physicians must use the Emeryville, Calif.-based company's online consultation system in order to receive payment from Aetna and Cigna. Doctors will have to pay an undisclosed monthly fee for the software.
RelayHealth, which competes with Medem Inc., a San Francisco company that is partly owned by the AMA, is one of the leading players in the online consultation services market. The company has signed deals with 13 insurers, including Cigna, Aetna and WellPoint Inc.'s Empire Blue Cross and Blue Shield.
The two plans said that they are reimbursing for online consultations for several reasons, including improving member satisfaction and access to care, meeting employer demand, and hoping that online consultations can help lower costs and improve outcomes. Depending on how things go with online consultations, the plans might expand reimbursement to other markets around the country, they said.
"We do these pilots [thinking] that they will be successful," Dr. Cutler said. "If we didn't think it was going to play out well we wouldn't do it."