Aetna and Cigna want to pay you for online visits

You normally can't charge insurers for phone care. However, if you belong to the Cigna and Aetna networks, there's a good chance you can now bill these insurers for treating their patients via the web.

Some insurers have been paying doctors for so-called virtual visits—conducted through secure electronic messaging—for a number of years, but usually on a limited scale. However, both Cigna and Aetna announced last December that they were reimbursing online visits on a nationwide basis in 2008 through a service called RelayHealth. It's one more sign that virtual visits may be ready for prime time—and some day, even eligible for Medicare reimbursement.

Cigna is expanding a four-state pilot project in cyber medicine to include employers with self-insured health plans across the country. The insurer will pay $25 for a typical online consultation. An example of that, says company spokesperson Joseph Mondy, might involve an established patient with a chronic illness who has questions about a flare-up of symptoms. Cigna would pay a maximum of $35 for more complicated consultations, Mondy says. The Cigna patient would pay his or her usual co-pay online at the RelayHealth website with a credit card, with the insurer paying the remainder of the charge.

Likewise, Aetna had been paying primary-care doctors, including pediatricians and ob-gyns, for online consultations through RelayHealth in four states. Now the insurer has taken the program nationwide, making coverage for RelayHealth consultations available to patients of most fully insured plans as well as self-insured plans that choose to participate. In addition, the insurer has increased the number of eligible specialties to 30. Aetna wouldn't disclose what it pays for online visits.

To participate in the Aetna and Cigna programs, a doctor must subscribe to RelayHealth (www.relayhealth.com), which costs $100 a month for the typical doctor. Cigna will foot the bill for the first three months if a network doctor signs up. An Aetna spokesperson says the insurer is working with RelayHealth to offer discounts to select physicians in select markets

In an online consultation through RelayHealth, patients describe their problem in a structured interview. All communications between doctor and patient are encrypted and password-protected, in contrast to ordinary e-mail. The online service also allows patients to request appointments, prescription renewals, and referrals as well as view lab results.

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