Telemedicine and house call options abound in Southern Nevada

By Nina King (contact)

Sunday, April 12, 2020 | 2 a.m.

It’s a scenario many of us have encountered: You think you need to see a doctor but aren’t eager to leave the safety of your home quarantine out of coronavirus concerns. What should you do?

Telemedicine could be an option — as long as it’s not for something requiring emergency services. Caring for patients remotely has been legal in Nevada since 2015, and has expanded over the years to accept Medicaid patients and license more out-of-state professionals to make finding a provider more easy.

Here’s some information on telehealth:

Who is able to use telemedicine? 

During this national COVID-19 emergency, anyone with access to a telecommunications device — landline, cellphone, computer or tablet — can reach a medical provider through telemedicine. Previously, only HIPAA-compliant devices and platforms were allowed due to privacy and security concerns, but that is no longer the case in Nevada. 

Check with your doctor or insurance company to see if they offer telemedicine services, what the format is and what devices might be required to access care. Many insurance companies offer this option, including Cigna, UnitedHealthcare, Southwest Medical, and Anthem Blue Cross and Blue Shield. 

Some use their own services from a website or app for members, whereas others link to alternative telemedicine providers. Most of those services require a copay and may have other costs associated, just as if you were in a doctor’s office. You may also need to download an app or sign up for a service that allows audio-visual contact, such as Zoom, Skype or FaceTime.

If you don’t have insurance, you can still access medical advice from some providers for free or at a low cost. FirstMed Health and Wellness Center recently announced its expansion and sees Medicare and Medicaid patients, in addition to low-income clients throughout the state. 

“More that 85% of our current patients have made a seamless transition and it works great,” said Angela Quinn, CEO of FirstMed Health and Wellness Centers. 

The company can also help guide you through how to sign up for Medicaid and evaluate your costs on a sliding scale. If you are a current Nevada Health Centers patient, you may be able to schedule a virtual appointment online.  

Nurse practitioner Peggy Pruchnicki, who owns Simply Radiant MedSpa, has begun offering telemedicine services in response to the coronavirus, with basic consultations starting at $20 on a sliding scale. Other providers accept insurance and many will provide a medical billing report to submit to your insurance company afterward.

What issues should you use a telemedicine appointment for? 

There is a wide range of reasons you might want to schedule a telemedicine visit, including immediate care — for example, suspecting you have a basic cold or flu, pink eye, sinus infection or ear infection. Pruchnicki, who worked in the Valley Health system for 10 years, talks to patients about problems like bladder infections, sore throats and medication refills. 

Many telemedicine services are available around the clock and often with minimal wait times. ResortCierge MD specialized in delivering health care to visitors via telemedicine or in-room visits but has now pivoted solely to telemedicine after Las Vegas hotels closed. They answer the phone 24/7 and offer appointments with professionals in as little as 15 minutes after receiving the initial call. AmWell and MDLive are two other telemedicine providers that work with many insurers, offering quick access as well. 

Primary care is also often available if it’s time to check in with your doctor about your medications, request lab work, follow up with your dietary plans or get referrals to specialists. Many of the reasons you would see your doctor in-office can be addressed through a telemedicine visit. 

For FirstMed, the telemedicine model is working well. “We have made telehealth available and easy [to] access,” said Quinn. “Where the light went off for our patients was the ease and safety ushered in by the pandemic. We have seen such a strong, positive response, we will continue some form of telehealth beyond the pandemic.”

Therapeutic counseling was one of the first uses of telemedicine and it remains an excellent resource for mental health. If you have an established provider, check to see if they offer appointments online or over the phone. 

Many providers are specialists — if you need a dermatologist, for example, you can talk to one. If you want to talk about your immune system, holistic doctor David Stella uses the telemedicine model to address nutrition, stress, sleep, hydration and more.

“I think, overall, the functional medicine side, the holistic side, is really going to come up in our awareness to how we can get our bodies in a state where we can be the most optimal against the common cold or flu or whatever that’s out there,” Stella said. 

Can you get a prescription from a telemedicine provider? 

Yes, if it is determined that you need a prescription, most of the providers can write that for you. They can also tell you if an over-the-counter option is more suitable for your symptoms.

What about COVID-19 screening?

If you want to be screened for COVID-19, there are numerous assessments online, including from many health insurers. The Southern Nevada Health District and CDC offer guidelines to help assess if you have COVID-19 symptoms. If you do have qualifying symptoms, you will need to check in with a health care professional, preferably your doctor, who will evaluate you and determine if you need to be tested. If you show emergency warning signs, such as trouble breathing, persistent pain and pressure in the chest, new confusion or blue face or lips, immediately seek medical help. 

House calls

There are also health care providers that exclusively offer house calls. Doctoroo, HealthCare Partners Nevada (for Medicare patients), Ready Responders and Dispatch Health are some of the companies offering this service in Southern Nevada. In the wake of the COVID-19 pandemic, some, such as Doctoroo, have seen their practices grow and added staff to keep up with demand. While some send doctors, you may also see nurse practitioners and assistants depending on the circumstance. This option makes sense if you need an in-person consultation but want to limit your out-of-home exposure. 

House calls are similar to going to the doctor’s office and there is a lot they can do for you from home, such as checking your vital statistics and providing services that would be common in urgent care or with a primary care doctor. This can include evaluating falls to stitching up lacerations. The medical staff will be masked and in gloves, offering a little more peace of mind. Most accept insurance, including Medicare and Medicaid.