Ralph Parker, M.D.

While Telemedicine may work well for certain types of practices and consultations, a surgical practice has certain inherent limitations with implementation. Many consultations require an actual "hands-on" examination and can only be performed in person. (Obviously, we will not be walking you through your own appendectomy.)

In a surgical office, telemedicine is best suited for non-urgent tissues or for postoperative follow-up visits after simple procedures. We can help you decide what is best for you when you call.

When you set up an appointment time, you will be sent a link via email or text to the teleconferencing website. You can also click on the sidebar on the right hand side of our HOMEPAGE.

This depends on the type and complexity of the issue. Conferences that are expected to last more than about 20-30 minutes may be complicated enough to warrant an actual office visit. This technology is best suited for relatively short visits and follow-ups, but may be used to make an initial determination as to the urgency of your issue.

The Covid-19 pandemic created many hardships on patients and has limited their ability to see a physician in a timely manner. We felt that if we could relieve some of the hassle for patients of coming to the office and at the same time reduce their potential exposure to infection, it would be of tremendous benefit.

In addition, we recognized that many patients may require only very brief follow-up office visits, yet they may have to take considerable time away form work or school to drive to the office for their appointment.

Lastly, we have a number of patients who live or work a significant distance from our office, including college students who can benefit from follow-up consults but cannot get away from work or classes easily or during office hours. This will provide the option of virtual visits without making the drive.

It depends.

Postoperative office visits are almost always included in the fees for the primary surgical procedure and are not charged separately—regardless if the visit is in-person or via teleconferencing.

Initial consultations for new patients or subsequent visits for established patients are charged similar to standard in-person office consultations. Patients are responsible for deductibles, copays and coinsurance according to their particular insurance plan—just like a regular visit.

Several commercial insurance companies consider telemedicine visits and charges the same as normal office visits and will provide payments after applicable deductibles, copays and coinsurance.

Most Medicare Advantage plans have agreed to cover charges associated with telemedicine consultations.

Traditional Medicare B recently approved coverage of charges when the patient initiates the conference from their home. Deductibles and coinsurance still applies.

No problem. In fact, telemedicine may be a good place to start.

Many patients without insurance hesitate to seek medical advice because they are afraid of being told they will require expensive surgery or testing. This can lead to unnecessary delay in care, or needless worrying. In some cases, a relatively quick teleconference may be all that is needed to get a good idea as to the problem and allow the physician to offer advice on how to proceed, or possibly just reassurance that no surgery is needed after all. This may be less expensive than a more lengthy formal consultation.

When you make the appointment for a teleconference, our office manager will obtain and verify your insurance information and check your benefits to determine any applicable deductibles, copays or coinsurance—just like during a normal office visit.

You will be provided an estimate of your charges based on your benefit plan and on our contracted rates with the insurance company. If you pay at the time you schedule the appointment, you will be given a passcode to be used when you login to the virtual "waiting room" which will speed the process at the time of your teleconference.

If you choose to pay at the time of the conference, you will be asked to enter the required credit card information on your device while you are in the virtual waiting room.

You always have the option of making a regular appointment for an in-person visit. However, you can simply pay for the virtual visit if you feel that it's worth the convenience of not having to take off from work or school, or if you live a long way from our office.

Telemedicine requires strict privacy standards and must meet HIPAA guidelines and other requirements. While Skype® and FaceTime® have similar functions, is remains debatable as to whether those services meet all of the above requirements.

The service we use is provided by doxy.me, a third party that provides the platform for facilitating an easy to use interface that is secure and HIPAA compliant. It uses 128-bit encryption for the conferencing and they do not store ANY of your information.

Telemedicine conferences (including audio-only conferences) are NOT recorded. In cases where the patient would prefer to upload documents, images or photos, they may initiate an upload during the teleconference and such images may be stored in the patient's medical record at our office; however, no images, documents or audio is stored by doxy.me, the company that provides the platform for telemedicine.

Nope. No special app is required. The system works with a standard web browser, such as Safari, Chrome or Firefox. When you connect, you will be asked to allow the browser to use your camera and microphone.

While you obviously need to be set up as a patient in our office, you do not need to create a separate account on the telemedicine website.

When you connect, you will be asked to enter a name just so we know who it is that has joined the conference. You need to use a name that we recognize as you when we see you in the virtual waiting room. (For example, if your name is "Bill Smith", you can enter "Bill S." or "B. Smith", but don't enter "Crazy Willie" or "@The REAL BS".)

Not really. A typical patient portal is a service that some offices use to facilitate communications between the office and patients. It may be used to send messages back and forth, and may allow patients to access their medical records or download labs and reports. Some portals may also incorporate videoconferencing functions as well. They typically require login usernames and passwords.

Implementing a portal with all of these functions can be an expensive hassle and might be more useful in a primary care setting where patients may want to access records from annual exams or a list of their medications.

Our system does not require setting up any user accounts or passwords. Just click on the provided link and enter your name. If you pay at the time the appointment is created, you will be given a one-time passcode to streamline the process.

We are just starting the service and will have scheduled appointment times for all telemedicine consultations. If we see that the service is useful to our patients, we may consider adding some time outside of normal business hours.