Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter I - Specific Policies By Service › Sec2 144-101-I-4 - Telehealth Services › Subsection 144-101-I-4.01 - DEFINITIONS

Current through 2024-29, July 17, 2024
4.01-1
Asynchronous Encounter
The interaction or consultation between a Member and the
						Member's Health Care Provider or between Health Care Providers regarding the
						Member through a system with the ability to store digital information,
						including, but not limited to, still images, video, audio and test files, and
						other relevant data in one location and subsequently transmit such information
						for interpretation at a remote site by Health Care Providers without requiring
						the simultaneous presence of the Member or the Health Care Provider. The term
						"Store-and-Forward Telehealth" is also used for the term "Asynchronous
						encounters" in this rule.
4.01-2
Consultative Physician
A physician who provides consultation services to another
						clinical provider who is actively investigating the health status of a
						Member.
4.01-3
Department
The Maine Department of Health and Human Services.
4.01-4
Health Care
					 Provider
Individual or entity licensed or certified to provide
						medical, behavioral health, and related services to MaineCare Members. Health
						Care Providers must be enrolled as MaineCare Providers to receive reimbursement
						for services.
4.01-5
Home Health Agency (HHA)
A voluntary, public, or private organization or a part of
						such organization that is certified under Title XVIII of the
Social
						Security Act
for reimbursement for the delivery of home health
						services, pursuant to Chapter II, Section
						40, Home Health Services, of the
MaineCare Benefits Manual
(MBM).
4.01-6
Interactive Telehealth
					 Services
Real time, interactive visual and audio
						telecommunications whereby a Member and a Health Care Provider interact
						remotely through the use of technology.
4.01-7
MaineCare Covered
					 Services
Services covered and reimbursed through MaineCare as
						provided in the MBM
.
4.01-8
Member
Any person certified as eligible for services under the
						MaineCare program.
4.01-9
Originating Facility Fee
Fee paid to the Health Care Provider at the Originating
						(Member) Site for the service of coordinating Telehealth Services.
4.01-10
Originating (Member)
					 Site
The site at which the Member is located at the time of
						Telehealth Service delivery. The site must be physically located in the United
						States.
4.01-11
Receiving (Provider) Site
The site at which the Health Care Provider delivering the
						service is located at the time of service delivery. The site must be physically
						located in the United States.
4.01-12
Synchronous Encounter
A real-time interaction conducted with interactive audio
						or video connection between a Member and the Member's Health Care Provider or
						between Health Care Providers regarding the Member.
4.01-13
Specialist
A medical professional highly trained in a particular
						medical field.
4.01-14
Telehealth Services
The use of information technology by a Health Care
						Provider to deliver clinical services at a distance for the purpose of
						diagnosis, disease monitoring, or treatment. Telehealth Services may be either
						Telephonic or Interactive and includes synchronous encounters, asynchronous
						encounters, store-and-forward transfers, and telemonitoring.
4.01-15
Telemonitoring Services
The use of information technology to remotely monitor a
						Member's health status via electronic means, allowing the provider to track the
						enrollee's health data over time. Telemonitoring may be synchronous or
						asynchronous.
4.01-16
Telephonic Services
The use of audio-only telephone communication by a Health
						Care Provider to deliver clinical services at a distance for the purpose of
						diagnosis, disease monitoring, or treatment.
4.01-17
Treating Provider
A medical professional who either is currently providing
						or has provided medical treatment, evaluation, or who has an ongoing treatment
						relationship with the Member.