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Remote monitoring is officially the new staple medical service for delivering value-based healthcare. RPM is becoming a standard in both primary and specialty care.
Collecting physiological data few times per year and making medical decisions (medication, exercise, diet) VS Collecting physiological data daily and fine tuning medical decisions (medication, exercise, diet)
Reactive Care VS Proactive Care (old way is patient has an extreme event like hospitalization then doctor reacts to patient condition vs new way is doctor gets an SMS alert of an adverse physiological reading and modifies the care plan to keep the patient out of the hospital)
Old Medium of Delivering Care VS New Medium of Delivering Care (old way is ad hoc visit clinic waiting room few times per year vs new way patient gets right sized and real time care based on their physiological data which reduces unwanted waiting room visits and increases more appealing virtual visits)
Current Doctor (blind with limited data and limited clinical support outside of working hours) VS Super Doctor (empowered with a wealth of data / data driven, trends, notifications, correlations, and 24/7 clinical support from an RPM services vendor)
Impact to Total Cost of Care - Huge Savings from RPM - Accuhealth alone saved the healthcare system $44M+ dollars in avoided Emergency and Hospital visits in 2021.
RPM is the use of digital technologies to collect and analyze physiologic patient data from one location and electronically transmit that information securely to providers in a different location. Patient data can include vital signs, weight, blood pressure, blood sugar, and/or pacemaker information.
We provide patients an EHR-connected monitoring device that monitors blood pressure, glucose, pulse ox, and/or weight. Devices send data automatically and digitally back to our platform and the provider's EHR.
When patients have abnormal readings, our 24/7 clinical team of nurses and MAs will call your patient, assess, and escalate only those cases that need to be escalated, minimizing disruption to you and your practice.
Our clinical team's interactions with your patients generates time towards the time-based RPM codes that you will bill Medicare (or other payer) monthly. We help you with billing details so that you can generate clean claims.
Improved Clinician Experience
Objective Data, 24/7/365 clinical support from RPM Vendors, More patient touchpoints using technology and virtual visits, Reduced Cognitive Overload, Increased Marginal Reimbursements.
Improved Patient Experience
Real-time and proactive care, 24/7/365 clinical support, virtual care in the comfort of the home, empowered with data to take ownership of their own health, less emergency, and hospital visits.
Lower Cost of Care
In 2021, Accuhealth alone avoid 3,271 hospital visits, saving CMS an estimated net savings of $44,485,600 based on an average Medicare cost per patient of $13,600 (found at peoplekeep.com).
And most importantly, Better Health Outcomes...
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Book an appointment with one of our client specialists using this link. Our client specialist will make sure that you understand the program and get your onboarding information loaded into our system, so that you can get started quickly.
Book an appointment with one of our client specialists using this link: schedule a demo
We would be delighted to answer any questions you may have. The Accuhealth Chat Bot is easily located in the bottom right corner of your browser window. Alternatively, you can book a demo by clicking here.
Accuhealth offers a nationwide English-and-Spanish-speaking team of nurses and MAs who provide first-line clinical monitoring of all vital sign data being captured by patients 24/7/365. When a patient’s biometric data exceeds a critical threshold (see below), our team will call the patient using our platform, on a recorded line, and make a clinical assessment. Our nurse will determine if the case needs to be escalated to the physician and if so, make contact with the physician. This sort of screening can help significantly reduce the burden of “noise” so that ordering physicians can deploy RPM with less stress and headache.
Many vendors do not offer any sort of clinical monitoring, leaving the clinic to have to respond to every single abnormal vital sign reading, even overnight.
Accuhealth offers physicians the ability to set both custom default thresholds for each vital sign (such as blood pressure, heart rate, or glucose), as well as custom thresholds for individual patients, because we’re not all the same!
Some vendors are not able to offer the level of customization that physicians should expect.
Accuhealth pays for and supplies all consumables to patients because it’s a key part of our patient compliance strategy.
Many vendors don’t offer or manage consumables, leading to lower patient compliance.
Although Bluetooth is great for non-critical technology, because of pairing, smartphone/tablet requirements, WiFi, accounts and password issues, we have found that the easiest and most reliable devices are those with built-in cellular chips that avoid all the complexity of Bluetooth and instead send their data wirelessly to our platform without any patient interaction. These devices cost us more money, but we believe in offering the easiest experience to our clients and their patients.
Many vendors rely on outdated Bluetooth devices because they are inexpensive. However, because patients will inevitably have issues with pairing, unpairing, logins, passwords, or WiFi connectivity, Bluetooth often leads to lower long term compliance with RPM.
We manage all device storage, fulfillment, shipping, and returns. We never expect physicians to store devices in their office or have to spend time distributing devices to patients.
Some vendors require physicians to purchase and store a large number of devices in their office and manage the distribution of the devices to their patients.
Accuhealth already integrates with more than 10 of the top practice-based EHRs and we’re always adding more integrations. If you have any of the following, we already integrate with your EHR:
Athenahealth
ECW (eClinicalWorks)
Greenway
Practicefusion
Nextgen
eMDs
Integrated Practice Solutions
Dr Chrono
Aprima
Kareo
Waiting Room Solutions
Or any web based EHR.
We will even build EHR integration with some non-web based EHR’s (Epic, Cerner)
Many vendors don’t integrate with any EHRs or if they claim they do, their integration isn’t robust or real. See the next question.
Our EHR integrations allow you to:
- order RPM directly from the EHR
- review patient readings (like blood pressure) in the vital sign fields
- see trends and run reports, which is especially important for quality reporting.
- generate automatic claims for RPM
Many vendors claim they integrate with EHRs but what they actually do is just upload a PDF or fax document into the patient chart. Since that data is not readable automatically by the EHR, this is not a true integration and also prevents the provider from running reports that are required for quality reporting.
Zero. We do it at no cost because we know each new integration is an investment that makes our product offering more attractive to our clients.
Many vendors charge $5,000 or more for EHR integration and that usually means they don’t actually offer it.
Accuhealth has a proprietary HIPAA-compliant SOC2- certified platform called Evelyn. Evelyn is a web-based solution in which providers and their clinical team members can log in to see all their patients’ RPM data, monitor compliance, see and add clinical notes, review billing data, and more.
Many vendors do not have a fully-integrated HIPAA-compliant software solution that connects devices to clinicians.
All monitoring, comments, and phone calls made to patients through the Accuhealth platform are automatically time stamped and recorded and become a permanent part of the audit record. This audit record is stored in the Accuhealth platform as part of the patient’s medical record and is also integrated with the patient’s medical record in the ordering provider’s EHR. This audit record includes the actual recorded audio files of the phone calls with patients and transcripts of those calls. We believe we have the best audit record in the industry.
Many vendors have minimal to no audit trail or their audit trail might be manually produced, creating the opportunity for human error and additional risk to the practice.
99453, 99454, 99457, 99458
99453 - Initiating visit with the patient to describe the program and get patient acceptance to participate. Typically, this is when the patient is provided an Accuhealth brochure. This is a one-time billable code, and the Date of Service is equal to the first successfully recorded reading that comes into Evelyn for the respective patient. This code reimburses typically between $15 and $20 depending on the locality.
99454 - This is for providing the monitoring device(s) to the patient, the software to ingest readings from the patient, and ensuring that both are functioning on an ongoing basis. This code is billed once every 30-days. The patient must record at least one successful reading in the 30-day period. The first date of service for 99454 is equal to the first successfully recorded reading in Evelyn, and is billed every 30-day calendar days subsequently. This code typically reimburses $55 to $62 depending on locality.
99457 - This is for providing between a minimum of 20 minutes of interactive telemonitoring services with the patient and/or patient caregiver over the calendar month. This time can be provided incident to and under the clinics general supervision, meaning Accuhealth can provide 100% of this time. It’s encouraged that clinics work within our platform, as any time spent by the clinic also goes towards this cumulative time. This code reimburses ~$49 across most localities.
99458 - This is for providing additional units of 20 minutes of cumulative interactive time spent providing telemonitoring services to the patient and/or patient caregivers. There is no limit to how many units of 99458 a clinic can bill; however, it’s legally recommended NOT to exceed more than 2 units of 99458. In other words, if a clinic records 40 to 59 minutes of time with a patient in a calendar month, they would submit a claim for 99457 and one unit of 99458. If a clinic spends 60 or more minutes, they would submit a claim for 99457 and two units of 99458. This code reimburses typically about $49 for each unit across most localities.
Use the CMS tool: https://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx
99453 can only be billed after 16 days of monitoring.
99454 should be billed only once each 30 days, regardless of the number of parameters monitored
Do not report any RPM codes in conjunction with 99091 (legacy remote patient monitoring code)
RPM can be billed in the same months as CCM, TCM, and BHI (but time spent doing one service, e.g., CCM, can not also count towards time for another service (RPM)).
Do not count any time on a day when the physician or qualified health care provider reports an evaluation/management service
Do not count any time related to other reported services (e.g., 93290)
May be billed as an "incident to" service
Billing provider must have at least one face-to-face visit with the patient in the preceding 12 months (this rule was relaxed during the COVID-19 PHE to allow for the face-to-face to be done via telemedicine). Face-to-face visits can include levels 2-5 E/M visits, Annual Wellness Visit, Initial Preventive Physical Exams, or the face-to-face from a Transitional Care Management encounter.
Billing provider must be a Qualified Healthcare Provider (QHCP = MD, DO, NP, PA).
The CMS has grouped RPM as part of CCM, but the State of Maryland has a special program (MDPCP) that bypasses that. Clinics that are part of the MDPCP program are not allowed to bill for CCM, but they are allowed to bill for RPM.
We ship devices to patients using tracking numbers and once the device has arrived, we call the patient to onboard them onto the program. We help them take their first measurement and make sure that their data is flowing appropriately into our platform.
Some vendors require the clinic staff to train patients on device usage.
We have a robust Patient Adherence program that includes the following:
- we pay for all the consumables (for some patients this is a big deal);
- when we call patients, we try to call with the same clinical team member if possible, in order to develop comfort and rapport;
- we enroll patients into our Bingo game in which patients can win prizes by participating in taking daily measurements;
- we use automated SMS reminders
Some vendors will just give you the device and expect you to figure out all the downstream issues yourself. If patients stop participating after just one or two months, your program will fail.
Just one. There is no requirement to monitor more than one physiologic parameter.
A lot of RPM vendors out there are over-promising and under-delivering.
Keep reading to understand the keys to success and industry secrets when selecting an RPM vendor, and what to watch out for, such as:
What to expect from RPM / Key KPIs to measure the success of your RPM PROGRAM
(Including significant Readmission Rate Reduction for Hospitals deploying RPM)
(without increasing cognitive overload)
RPM should generate significant revenue for your practice and quickly become a top line item in your Medicare claims.
(avg patient churn is <2% and patients are "sticky" to the Provider that is analyzing their physiological data and better managing their care plan)
(Improved patient engagement and experience)
and in fact. see your patients more regularly in-person.
Hardware is one of the most important components of any RPM program. Since your patients will be using them on a daily basis to collect the physiological reading the RPM devices need to be extremely user-friendly, accurate, and reliable, particularly with our elderly patients. Look for simple to use technology that is plug and play straight out of the box.
You should never have to manage device inventory or purchase any devices up front, nor have to pay for device consumables.
Your RPM provider should also have a full product suite / wide range of remote patient monitoring devices, including but not limited to:
All of these devices should also work on the same technology (Bluetooth vs cellular).
For example, TELLI HEALTH (pictured above) offers a full suite of devices with cellular connectivity and rechargeable lithium-ion batteries and great customer support.
RPM is both technical and cumbersome, something that cannot be delivered independently by a healthcare professional, regardless of size and scope. It is important to choose an RPM vendor that will manage as many components of the RPM process as possible (and preferably ALL components of the RPM process). The essential components include:
These are all critical components for successful RPM delivery.
Get valuable insight into how Accuhealth can increase measurable outcomes, from family clinics to FQHCs, there is a solution tailored to your needs.
In order for RPM to work you need to be able successfully scale. While putting one or two people on RPM might help those patients, it does not give you the total view of all your patients unless you have vast amount of your patient census subscribed to the service. If the program works for 1 or 2 patients, just Imagine the potential for hundreds of your patients.
EHR integration is imperative for the success of any RPM service. Make your RPM vendor explain how their integration works, and ensure that is not just a flat file, and that they have the ability to put patient vitals directly into the patient's chart for easy viewing.
What is the RPM providers patient engagement plan (to keep patients engaged for many months)? Without patient compliance/adherence, there is no RPM program.
Utilize regular personalized HIPAA compliant messaging, based on the patients/providers' preference via SMS, phone or Telemedicine video call. Keeping the patients engaged, educated, and empowered is important to improving their health outcomes.
Hear from patients using Accuhealth RPM
Thank you my friend n have a safe n Blessed day n may it be a joyful weekend😇😊
Thank you, Evelyn. It's a beautiful day. Have a great week. Stay safe.😊🙂
Thank you for clearing this up. Have a good evening.
Thanks 👍 for reminding me 🙂 to check my blood pressure every day that's like a real blessing to me 🙏, thanks again for the reminder 😘 It's like a real blessing.
Good morning Evelyn, I was just thinking about you. Thank you for all your hard work and for taking such good care of me.I hope you have a wonderful and joyful Christmas. The world is a much better place with you in it.
A lot of doctors are concerned that RPM is going to take over their life with 24/7 care, but the reality is that most patients take their readings between 5am and 5pm, typical clinic operating business hours.
A lot of physicians are concerned that they will be paying for a service without successfully being able to bill.
Pick a partner with a proven track record of successful billing so that they will be able to deliver on their promises and that your clinic can run a successful RPM program.
Many clinics who have worked with providers with rigid billing terms and long term contracts. At Accuhealth we believe in partnerships and understand that sometimes claims are denied. You want a provider who will work with you to ensure your CPT code billing is effective and runs smoothly, as well as helping to process any rejected claims.
A lot of physicians are worried they won't see their patients anymore.
What actually happens is you see your at risk patients more often as you have better metrics on how they are doing in between visits and your healthy patients still come in on their regular cadence.
Specialization - pick an RPM provider who specializes in RPM! Many of the provider out there will claim to be RPM experts when in fact RPM is something they only do as an added service.
As a physician, we all know medical services we render will generate revenue, and it is important to make business decisions on which medical service is worth the investment patient-wise as well as business-wise. However if an RPM vendor first communicates HOW MUCH MONEY YOU CAN MAKE, this should be a red flag and a warning that this RPM vendor might not be the one for you.
Your RPM program should always be patient-care/quality of care focused, rather than revenue-focused. The goal of remote patient monitoring is to reduce the overall cost of care, and if an RPM provider Is focused on revenue, they probably don't understand how RPM works. If you provide the highest quality of care, patients will stay with you for longer and more patients will adopt your RPM program.
Ask for documented proof of how their program helps the patients have them explain the full process of RPM end to end how it works and try to poke holes in their story. For example, are you buying devices and sending them to patients? Do you have space in your office to manage inventory? Who troubleshoots the devices if they are not working? Are they available 24x7 to help you or your patients?
Click on the links below to red a few case studies about the benefits and outcomes of our RPM solution from clients.