 The Service is otherwise covered under this EOC if received in person;  The Service is Medically Necessary;  The Service is determined to be safely and effectively provided using telemedicine, according to generally accepted health care practices and standards.  The technology used to provide the Service meets the standards required by state and federal laws governing the privacy and security of protected health information; and  For audio-only telemedicine, the Member has an established relationship with the provider. For purposes of this section, “established relationship” means:  The Member must have had at least one in-person appointment or at least one real-time interactive appointment using both audio and video technology in the past 3 years (for mental health, Substance Use Disorder or behavioral health treatment), or in the past 2 years (for any other health care Service), with the provider providing audio-only telemedicine, or with a provider employed by the same medical group, at the same facility, or by the same integrated delivery system operated by Kaiser as the provider providing the audio-only telemedicine; or  The Member was referred to the provider providing audio-only telemedicine by a provider with whom they had an in-person appointment within the past 3 years (for mental health, Substance Use Disorder or behavioral health treatment), or in the past 2 years (for any other health care Service). Telephone and E-Visits We cover scheduled telephone visits with a Participating Provider. To schedule a telephone visit, sign on to kp.org or the Kaiser Permanente app, then select “Appointments” or call Member Services. We also cover e-visits. To access an e-visit, log in to your kp.org member account on your desktop, laptop, or tablet and fill out a questionnaire about your symptoms. A nurse will get back to you with a care plan, usually within six hours. If needed, a prescription may be sent to your pharmacy. E-visits may include secure chat instant messaging. To learn more about interactive audio and video communications, telephone visits and e-visits, including a short instructional video and troubleshooting tips, visit kp.org/telehealth/northwest. 37. Temporomandibular Joint Dysfunction (TMJ) Medical Services for Medically Necessary treatment of temporomandibular joint dysfunction (TMJ) are covered subject to Utilization Review by Kaiser using criteria developed by Medical Group and approved by Kaiser. Non-surgical outpatient Services are subject to the Cost Share shown in the “Benefit Summary” . Surgical Services, such as orthognathic surgery, are subject to the hospital Services Cost Share and outpatient surgery Cost Share. 38. Tobacco Use Cessation Kaiser supports various options for quitting all forms of tobacco use. Our “Freedom from Tobacco” classes include:  Relaxation techniques.  Understanding tobacco addiction.  Practicing effective ways to remain tobacco free. These health education classes are offered through Kaiser. Members do not pay a fee to participate. For more information or to register, see Kaiser’s Healthy Living catalog, call Member Services, or go to kp.org. To use EWCLGHDHP1983ACT0124 70 WAPEBB-CD-ACT

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