Wiki Billing for a remote visit via Skype

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Anchorage, Alaska
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We have counselors who have performed visits with patients in bush Alaska (accessible only by air or boat) via Skype from Anchorage and were wondering if utilizing Skype would be considered "face to face". In my opinion, it would be, since the counselor is able to make visual observations on the client's demeanor and response to the counseling, as well as make assessments on the client's general appearance.
Does anyone have any information on how payers view using Skype?
 
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