Care Management is a client-centered approach designed to help clients and their support systems, including family members, effectively manage chronic disease. Successful care management is designed to enhance care coordination, reduce the risk of complications, and prevent costly hospital admissions and re-admissions.
Remote Patient Monitoring (RPM)
Remote Patient Monitoring (RPM) encourages patients and clients to take control over their health while enabling practitioners to gather vital information between office visits. It allows patients to monitor patient's health information while increasing patient engagement from the comfort of your own home, workplace, community, or wherever you may be.
RPM was designed to help providers care for their patients and clients outside of the confines of a traditional office setting. Patients use connected devices at home --- such as heart devices and blood pressure cuffs -- that automatically upload their health data through the cellular network to their doctor. Patients already take steps daily to help combat their chronic health issues, but we offer solutions so that no measurement or data is missed.
Medicare increased reimbursement for an average of $120 per patient per month when a provider is enrolled in a qualified program. The RPM care management program can closely monitor the most vulnerable patients with ease.
While virtual care solutions such as remote patient monitoring have been deployed to support patients with physical health conditions, there are not many remote monitoring solutions that collect qualitative data to engage and support patients with mental health and social determinant needs. Powered by HealthviewX, our solutions are powered to support population health teams in assisting patients with diabetes, kidney disease, depression, anxiety, substance abuse, and social determinants of health (SDoH).
Remote Patient Monitoring (RPM) Solutions by Type
Periodic or ongoing measurement of blood sugar levels help detect noteworthy changes in blood sugar levels.
Kidney Disease (Chronic Kidney Disease and End Stage Renal Disease)
Remote patient management (RPM) offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes.
Depression (Major Depressive Disorder) Survey results can enable care team action, recorded in a longitudinal analysis to help healthcare workers identify and support those who may be struggling with suicidal ideation or more acute concerns.
Substance Abuse (Substance Use Disorder)
Survey results can be tracked and monitored, showing when patients need additional support or resources to avoid a dangerous relapse.
Social Determinants of Health (SDoH)
If a patient responds with worry or general concern, the system logs the answer and triggers a provider notification indicating that the patient needs to have a ride arranged. This one transaction can not only improve health outcomes but allow the provider to eliminate an expensive, invasive, or at-risk procedure in the future.
How it Works
Enroll in our RPM program.
Enroll patients by adding information into our system and designating which device you would like for them to receive.
Submit the application on behalf of the patient and they will receive the device either in their home or office.
Reviewdata from the device in the client Portal or integrated EMR/EHR. Staff are notified if a patient's readings enter a specified caution or range, and reports can be customized to best fit your workflows. If you are logging time towards RPM management billing codes, it tracks this data as well.
Get paid by the billing system that generates a report every month showing all billable RPM codes for each patient. Fees are charged only for the billable RPM patients and include the connected device, cellular service, hosting, and customer support. Submit your claim at the start of each month. Fees are not due until after you receive the Medicare payment.
Increase Practice Income with RPM
Physician Fee Schedule Final Rule 2021 Remote Physiologic Monitoring involves the collection and analysis of patient physiologic data used to develop and manage a treatment plan related to a chronic and now acute health conditions. There are two practice expense only codes: CPT Codes 99453 and 99454. These codes are valued to include clinical time, supplies, and equipment including medical devices for RPM. There are two treatment and management codes: CPT Codes 99457 and 99458.
REQUIREMENTS FOR BILLING:
Eligible patients • Medicare patients with chronic and acute conditions. • During the PHE, new patients and established patients. • After the PHE, established patients Patient consent to receive RPM services may be obtained at the time RPM services are furnished.
Eligible providers • Only Physicians, Nurse Practitioners and Physician Assistants who are eligible to furnish E&M services can bill RPM services. Medical devices supplied to the patient as part of RPM services • Must be a medical device as defined by Section 201(h) of the FDA • Must be reliable and valid. • Must electronically (i.e., automatically) collected and transmitted rather than self-reported. Providers collect bio-metric data remotely including but not limited to weight, blood pressure, heart rate, oxygen saturation, blood glucose, temperature, and pulmonary function tests.
The average reimbursement for RPM is $120 a month per patient. With only 50 patients enrolled in the program, this is $72,000 per year.
First Month: Initial Enrollment 99453: Initial patient setup and enrollment into RPM program. Averages $21.
Base Monthly RPM 99454: Remote monitoring and management of device readings. Averages $64.
Care Management (20 min.) 99457: 20 minutes of clinical staff time communicating with patient or caregiver. Averages $55.
Care Management (40 min.) 99458: 40 minutes of additional clinical staff time communicating with patient or caregiver. Averages $44.
Care Management (60 min.) 99458: 60 minutes of additional clinical staff time communicating with patient or caregiver. Averages $44.
Are you a healthcare provider interested in learning more about how the RPM solution can increase your practice's revenue potential? Do you have Medicare patients on your patient panel who could benefit from RPM or a care management solution?
Contact us via e-mail at email@example.com or click here to complete and submit a Physician Referral Form to learn more about the RPM solution.