Before Your First Telehealth Visit: An OT Practice Checklist

Confirm where you may practice

Build a state matrix that records your license or compact privilege, the relevant board source, telehealth-specific requirements, renewal date, and limitations. Confirm the client’s physical location at the start of each visit and document it in the clinical system. AOTA’s telehealth decision guide treats both practitioner and client location as regulatory considerations.

Check more than licensure. State telehealth consent, prescribing, supervision, documentation, emergency, and professional-disclosure rules may differ. Payer coverage can also differ from permission to practice.

Decide when telehealth is a good fit

Define when virtual care is clinically appropriate, when an in-person evaluation is needed, and when you will refer. Consider cognition, communication, sensory needs, fall and environmental risk, technology access, caregiver role, privacy at the client location, and your ability to observe or measure what the service requires.

Make the virtual format part of clinical reasoning rather than a default. Document the rationale, limitations, adaptations, outcomes, and any transition to another format.

Check every tool that could touch PHI

Inventory every device, app, network, recording setting, calendar, intake form, email tool, storage location, and support workflow that could touch PHI. HHS says covered providers using remote communication technology must comply with HIPAA and use vendors that will enter appropriate business associate agreements when required.

Treat a vendor’s “HIPAA compliant” label as the beginning of your review. Confirm the contract, BAA availability, access controls, encryption, retention, deletion, breach notice, subcontractors, support access, and the exact product tier covered. Disable recording unless it is necessary and separately governed.

• Unique accounts and multi-factor authentication
• Private workspace, headphones, and screen positioning
• Secure updates, backups, and device-lock settings
• Minimum necessary access for staff and contractors
• Written downtime and incident procedures

Write the first five minutes of every visit

Confirm any state or payer consent language, when it must be renewed, and how it must be documented. At each visit, verify identity, client location, privacy, who else is present, a callback number, and the plan if video or audio fails. Explain material privacy and technology risks in accessible language.

Use telehealth consent forms tailored to your payers, states, and workflow. Have qualified counsel or a compliance professional review the final forms and process.

Plan for trouble at the client’s location

Know the emergency resources for the client’s location, not just yours. Define how you respond to falls, medical symptoms, suicidal statements, abuse concerns, unsafe equipment, a disconnected visit, or a client who cannot be reached. Record an emergency contact and the circumstances in which it may be used.

Practice the script and escalation path with fictional data. If a caregiver or facilitator is required, define their role, availability, consent, and boundaries before the session.

Confirm payment and documentation

Check whether the payer covers the service, provider type, client location, modality, code, modifier, and place of service on the date of care. Save the payer source and verification date. Coverage policies can change independently of professional licensure rules.

Your documentation should support the OT service, client-centered clinical reasoning, modality, locations, consent when required, participants, time, technology interruptions, and outcomes. Keep clinical records out of the Founders business-planning workspace.

Do a dress rehearsal

Test scheduling, reminders, consent, identity and location verification, video and backup audio, screen sharing, payment, documentation, follow-up, and a records request. Repeat on the devices and networks you actually intend to use. Fix the awkward handoffs before they become a client experience.