Remote Care Management

Comprehensive Remote Care

Remote patient monitoring (RPM) is a technology that enables real time tracking of patient’s vital signs and gives you the ability to provide care management at any time and from anywhere, with the goal of improving quality of life.

Remote patient monitoring is reimbursable care management service today with most of insurance plans. It can work seamlessly with our Telehealth solution to provide comprehensive remote care, including Chronic Care Management (CCM) and Transitional Care Management (TCM).

 

Maximized Reimbursement with our RPM

Current reimbursement models allow you to bill insurance for the patient to receive care from the comfort of their home. However, most RPM programs on the market require patients to use smart phones. It becomes a barrier to make RPM more practical and profitable.

Our system is perfectly positioned to help maximize this opportunity for you and your patients. Our Blood Pressure Devices, Digital Weight Scales, and Blood Glucose Monitors are all free to your Medicare patients. When a patient receives a medical device, it’s fully configured and ready to use out of the box — no smartphone, app, Bluetooth, or WiFi required.

How It Works

Sign Up

Contact us and sign up for our medical solutions. We will ship the devices to your clinic.

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Set Up

Setup appointment with patient for enrollment and setup. Our customer support will walk you thru the whole process.

Review Data

Review patient data and have a MA or nurse to call your patient for their status. At least 20 minitues per patient per month is required to bill 99457. Document it in care management system.

Get Paid

Bill to insurance plan and get paid. You can download the billing report from our system to bill Medicare for CPT 99453, 99457, 99458 and 99454.

Integrated Care Management

Chronic Care Management (CCM) + Transitional Care Management (TCM)

The CCM + TCM service is extensive, including structured recording of patient health information, an electronic care plan addressing all health issues, accessing care management services, managing care transitions, and coordinating and sharing patient information with practitioners and providers outside the practice.

CMS requires the use of certified EHR technology to satisfy some of the CCM scope of service elements. In furnishing these aspects of the CCM service, CMS requires the use of a version of certified EHR that is acceptable under the EHR Incentive Programs as of December 31st of the calendar year preceding each Medicare PFS payment year (referred to as “CCM certified technology”).

 

Why does it matter to me?

According to the Center for Medicare & Medicaid Service (CMS), CCM is recognized as one of the critical components of primary care that contributes to better health and care for individuals, as well as reduced spending. Medicare now pays separately under the Medicare Physician Fee Schedule (PFS) under American Medical Association Current Procedural Terminology (CPT) code 99490, for non-face-to-face care coordination services furnished to Medicare beneficiaries with multiple chronic conditions.

What are the examples of chronic condition?

Examples of chronic conditions include, but are not limited to, the following:

  • Alzheimer’s disease and related dementia
  • Arthritis (osteoarthrities and rheumatoid)
  • Asthma
  • Atrial fibrillation
  • Autism spectrum disorders
  • Cancer
  • Chronic Obstructive Pulmonary Disease
  • Depression
  • Diabetes
  • Heart Failure
  • Hypertension
  • Ischemic Heart Disease
  • Osteoporosis

Practitioner Eligibility

Physicians and the following non-physician practitioners may bill the new CCM service:

  • Certified Nurse Midwives
  • Clinical Nurse Specialists
  • Nurse Practitioners
  • Physician Assistants

Only one practitioner may be paid for the CCM service for a given calendar month.

Reach Us

We are located in sunny Phoenix, Arizona but frequently travel to the east and west coasts.

4450 N 12th St #210,
Phoenix, AZ 85014

Contact CAIN Health