Physicians & Professionals: RPM FAQ
What is Remote Patient Monitoring (RPM)?
Personal health and medical data collection from an individual with a chronic condition using FDA approved devices such as a blood pressure monitor at home. The data is transmitted to their medical provider in a different location to assist in care and related support. FDA approved devices like Blood Pressure, Glucometers, SP02 and Scales now have built-in cellular technology that transmits the data to a HIPPA secure platform that is accessed at the physicians’ office. No Internet is required. Medicare has recognized that new technology helps patients better manage their chronic conditions at home, potentially reducing ED/hospital stays, and created new CPT codes as an incentive to providers to engage with elderly patients more proactively, in addition to traditional periodic visits when a patient’s condition has escalated. To drive this initiative forward, Medicare compensates providers an average $123 per patient per month.
Which patients are eligible to participate?
Eligible patients are those with Medicare or Medicare Advantage plans who have at least one chronic condition and have consented to participate in a remote patient monitoring program.
How much will remote patient monitoring cost my patients?
Remote Patient Monitoring is a covered service under Medicare. Most Medicare Advantage Plans (MAP) and some private insurers are now covering RPM. Patient co-pay or deductible may apply to remote patient monitoring services. A majority of patients also have a secondary insurance including Medigap, Medicaid, or employer sponsored secondary plans, that will cover co-pay costs.
How much training will my patients require?
All devices are designed for seniors and very easy to use. They have simple displays, are ready for use out of the box, and automatically begin transferring the data when used. No calibration is needed for the blood pressure device. Our customer support team will reach out to each patient once the device is received to help with setup and are available to answer any questions or issues that may arise.
How much do I get paid?
Providers bill $123.00 per patient per month for the device and for reviewing the data from the devices for 20 minutes. The review of the patient data can be delegated to someone in the practice or our company can review the data. Please see the billing chart with CPT codes in the section “Remote Patient Monitoring”
How do I sign up for RPM?
Just call our office at 770-225-4478. We will ask for basic information about your medical practice (name, address, etc), including a valid National Provider Identifier (NPI).
After you sign the license agreement (Affiliate and Business Associate’s Agreements), you will be eligible to start enrolling eligible Medicare patients who have at least one chronic condition in the RPM program (with patient consent).
We will schedule a training session with your practice to get you up and running. We will train your front office staff to identify ideal patients and ensure the patient qualifies for reimbursement. Additionally, our company will meet with your biller to ensure that reimbursement is submitted correctly.
How Much Does RPM Cost My Practice?
The practice typically will pay a percentage of the money collected for RPM. This is around 25% which covers the cost of the monthly rental of the device as well as the software support for RPM. No money is collected until the practice receives money from the billing of the CPT codes.
How do I get devices for my patients?
Enrolling a new patient is easy. Once you have identified a Medicare patient with at least one chronic condition and obtain their consent, usually in the office, you can enter their basic info in the new patient screen. Once that is done the system will generate an order and the device will be shipped. More than one device can be ordered such as “patient needs an SP02 and a blood pressure cuff”, however Medicare pays for only one device a month ($69.00, we charge the practice $10/per month/per device). We will ship the device(s) to the patient and follow-up with a phone call to assure they are comfortable with using the device. We encourage the patient and/or caregiver to call our company, not the doctors’ office with any device questions.
What if my patient has questions?
We encourage them to call our company if they have questions. They can reach our customer service by calling 770-225-4478 anytime. Our number is displayed on the device itself.
Where can I track my patients’ activity?
Each practice that participates in RPM has their own unique HIPPA secured platform with their practice name as the “company”. The Saas (Software As A Service) software can be accessed from any device such as a computer, laptop, tablet, or phone and contains all the information you need to monitor your patients’ activity. Once they start using the device(s), you can track their usage in their patient account. You can also see all of their health information.
How does the doctor’s staff review the data?
During the course of the month the patient account is accessed and reviewed to determine if their chronic illness is being maintained, improving or worsening. Every second of time is logged automatically when in the patient account to help meet the monthly billing threshold. This can be done by an MA or other qualified health professionals. In addition, and under the doctors’ supervision, our qualified MA staff can also provide the entire service delivery of RPM for an additional fee. This is perfect for busy practices, especially for the first few months as you are building your RPM program. Over time, and as the money comes in from billing the RPM CPT codes, the doctor should be able to hire an MA to run RPM and other office functions.
How do notifications work?
The doctor and their staff directs our company to initially set parameters for patients whose measurements are outside of normal range such as “BP over 150”, “glucose over 150”. Once these are established notifications are sent via email or text (or both) to the appropriate clinician for follow-up with the patient for related care and support. This might mean an office visit for necessary tests to abate the exacerbated condition and prevent a hospital admission.
Also, notifications can be sent if the patient is not using the device. Notifications can also be directed to be sent to the caregiver.
How does the consumer facing app help the patient and/or their caregiver?
The patient and/or their caregiver can access the app through the Apple or Android store on their phone. Once they sign up and add their device(s) they can be tracked through the app. Because we use open source technology, a fitbit, Apple or Android watch can be added to the app as well for a more enriching experience for the caregiver and the patient. The same notifications that are sent by the doctor can be sent to the caregiver such as “remember to check your blood pressure”.
What do I need to do each month?
Each month, you will be notified to review your patients’ activity via our RPM platform. Billing reports show which patients are meeting the billing threshold. Your biller will submit reimbursement to Medicare for this review activity. During the course of the month review patient records for compliance. The 2 billing components are the device and time. The billing codes are explained in the section ”Remote Patient Monitoring”.
What if my practice is ever audited for RPM compliance?
The software saves every communication, chart review, health review, by clinician so that if ever audited there is a trail and back-up records maintained by our company through the doctors portal. RPM is here to stay and there should be no concern that Medicare will stop paying for RPM because it is proven to help patients improve their chronic conditions and avoid ER and hospitalizations.