Remote Therapeutic Monitoring

Table of Contents:

• Eligibility Rules
• CPT Rates
• Consent
• Add RTM
• Manage RTM
• Clinical Time Logging
• Approve Time

Eligibility Rules:

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• Applicants must have at least one chronic condition.
• Applicants must have active insurance.
• Applicants must be 18 years of age or older.

CPT Rates:

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• There are five CPT codes associated with RTM.
• The details of these CPT codes, including their applicable rates, are provided below.

Instructions:

• Click the RTM tab on the patient dashboard.
• As shown, there is an accordion at the top of the page. You can expand or close it as needed. By default, the patient details accordion is closed.

• When the expand button is clicked, you can view the expanded Patient details as shown below.
• On the left side, you can also see a call icon next to the Mobile number. This icon allows you to call the patient directly on his cell.

1. Please click “Add RTM episode” to access the “Consent” tab.
2. At the top, you will see a wizard containing the following sections:

• Consent
• Chronic Diseases
• Devices
• Critical Alerts
• Interactions

Consent:

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• If the patient agrees to participate in the RPM service, please click "Accepted by patient" and submit.

• The consent can be viewed in two languages: English and Spanish.
• By default, English is selected. Below is the consent screen in Spanish.

• You may enter the consent date and time manually for dates in the past; however, there are restrictions for future dates and times. By default, the current date and time are displayed.

• If the patient disagrees, select “Rejected by patient” and submit. This status can be edited later.

• Accept the consent and click “Next” to enter the “Chronic Diseases” tab.

Add RTM:

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• Once you have submitted the consent, the Chronic Diseases section will appear. After the consent is submitted, you may navigate to any section at any time.

• You may add chronic diseases by clicking the "Add" button next to the relevant label. A Chronic Care Problems pop-up will appear. To find the condition, click the Search button and enter the appropriate details. Complete the remaining fields with the required information, then click "Save" to submit. If you need to abort the process, click the "Cancel" button to cancel adding the chronic disease.

• To add an allergy disease, click the “Add” button next to the relevant label. A pop-up will appear for allergies. From the dropdown list, please select the allergy name, and then specify the severity based on your condition. You must also enter the date the allergy was recorded and the allergy status. Complete the remaining required fields, and then click the “Save” button. If you need to stop the process, click the “Cancel” button to abort adding the allergies.

• Please review the list of Active Medications prescribed for the patient below the allergies section. From here, you may add new medications, edit existing entries, activate or inactivate medicines, and delete medicines as needed.
• To add medications, click the "Add Medicine" button on the right. The Add Medication pop-up will appear. To set up a prescription expiry reminder, check the box and choose one of the two options: Remind before 5 days or 10 days. Then click the "Add Prescription" button to save your selection and add the prescription.

• To edit any medicine, click the corresponding Edit button. After you click the Edit button, the Update Prescription pop-up will appear. Make the changes you need and then click the Update button.
• To inactivate a medicine, switch the toggle to the OFF state. The medicine will then be inactivated.
• To activate the medication, switch the toggle to the ON state. A pop-up will open, and you will need to select the date through which you would like the medication to remain active. Once you have selected the date, click Update.

• When you select "Next", you will be taken to the device details tab.
• The Devices section is organized into two subsections: Assign Details and Order Details.

Assigns Details:

If a patient does not have any devices assigned, the Assign Details section will display an empty state. To assign a new device, please click Assign Device. A pop-up window will appear, allowing you to enter the following information:

• Select the device name.
• Select the device model.
• Enter the Device Serial Number (the device’s IMEI number).
• Select the device assigned date.
• Set the Device Status to Active.
• Click Add to complete the device assignment.

• Repeat this process for each device you need to assign. Once assigned, the device details will be visible in a table with columns for Device Name, Device Model, Device Serial Number, Device Assigned Date, and Device Status.

• You can edit or delete devices directly from the table using the respective icons. Clicking Edit will open a pop-up where you can make changes and click Update to save them.

Order Details

To order a new device, click on the Order Details tab and then click the +Order New Device button. This will open a pop-up form with the following fields:

• Shipping Name: The patient's name.
• Device: Select the device from the list. The list will only show devices that have been enabled at the center level.
• Email: The patient's email (optional).
• Shipping Address: The address where the device should be shipped.
• Country: Select the country.
• State: Select the state from the chosen country.
• Shipping City: Select the city from the chosen state.
• Postal Code: Enter the correct postal code.
• Order Note: Add any specific instructions or comments.

If you choose Blood Pressure Monitor, you will see an additional dropdown below to select the size. You must select a size when you choose Blood Pressure Monitor.

• After completing the form, click Submit. The order will be added as a new record in the table. You can review the order details by selecting the eye icon, which will open a sliding window.

Ordering Supplies:

If your device requires supplies, you may place an order by entering the desired quantity and selecting the +Order Supplies button located above the table. The supplies will be shipped to the same address used for the device order. After the order is successfully processed, a corresponding record for the supplies will be displayed in the table.

Once you have updated the devices, click "Next" to proceed to the Data Monitoring section.

1. On this tab, if there are no readings available, the system will display the following empty state:
2. You will see the pill box readings, organized into two columns: AM and PM. If the patient takes the pills, they will be marked as taken; otherwise, they will be marked as missed, as shown below.

• After you open Data Monitoring, click the Next button. The Interaction Screen will appear.
• On this screen, all patient and Medical Assistant interactions will be recorded. To add an interaction, click the Add Claims button. You can view the pop-up as follows:

• Please complete the required details, then click on the "Add Button". You can review it in the list using the steps below:

From clinical time, you can manually add the bill by clicking on the add icon.

• Service - The service will be auto-populated as ccm.
• Activity - Activity will be auto-populated as billing.
• Date - Select to which date you would like to be billed.
• Duration - The amount time you would like to add.
• Notes - Add a note that is related to the billing.

When adding the record, it will be saved in the clinical time section.

Manage RTM:

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• After enabling RTM, you can update Chronic Diseases/Allergies by hovering over the Conditions. Two actions are available: Edit and Delete. Selecting the edit icon will open a pop-up window, allowing you to make updates to the Conditions as follows:

• Upon clicking the icon, the “Chronic Care Problems” pop-up opens as follows:

• You cannot update the condition; only the condition details may be updated. Please ensure that you also add the Condition Status.
• Regarding editing or updating allergies, you may update any fields within the pop-up.

• Once you have made your updates, click the “Update” button, then select “Cancel” to discard the changes.
• Regarding medication details, you will not be able to edit the medication-related data. However, you can edit only the time and the refill reminders.

• When transitioning to the next section, you may edit a device by selecting the Edit icon on the device record. To remove a device, click the Delete icon. After completing your changes, please click the Update button.

• You can view all reported pill box readings here.
• Please click the refresh icon to reload the section and review any additional generated pill box readings.

10. Your updates will be applied. You can move between these sections using the Previous and Next navigation buttons at the bottom of the page.
11. In the interactions section, click the Edit icon to update the bill details.

• When you click the Edit icon, you can view the pop-up as follows:

• Once you have made the required changes, please click the Update button.
• You can access the RTM History from the right-hand side by selecting the corresponding button. After you click the button, a small overlay will appear, displaying the service history as shown below.

Discontinue RTM:

You can also discontinue the RTM episode by clicking the Discontinue Service button, located next to the RTM History button in the top-right corner. After you click Discontinue Service, a pop-up modal will appear. In that modal, you will be prompted to enter a reason for the discontinuation in the provided text box.

• Once the service has been discontinued, you may add, edit, or delete any chronic diseases, devices, data monitoring entries, and interactions.

Resume RTM Service:

• If you would like to resume the service, please click the Resume Service button, located next to the RTM History button in the top-right corner.
• After selecting Resume Service, you will be directed to the consent page. Please review and accept the consent in order to continue. Once the service is resumed, you will receive the previous data and will be able to take the required actions to add, edit, or delete the information.

• When you add the record, it will be saved in the Clinical Time section.
• There are several options for adding a bill.
  1. From Patient Listing.
  2. From Patient Dashboard.
  3. Manual Log Entry from Clinical Time.

From Patient Listing:

• As shown in the image above, when you click on any service RTM in the patient listing, you will see the following pop-up.

  

• If you select Yes, the timer will begin (billing will start), and you will be taken to that service within the patient dashboard. If you select No, you will still be directed to that service in the dashboard, but billing will not be initiated.

Billing Flow:

• If you have selected the APCM service and then clicked Yes to bill the time, you will be taken to the service with the billing timer ON. This action will disable other services, because when you are billing for a specific service, you are not able to navigate to other services such as CCM, PCM, TCM, RPM, or AWV.

• If you would like to stop billing, please click the STOP icon at the top near the header, as shown below.

• Once you have stopped the billing, the remaining services will be enabled, and the updated charges will be reflected in the Clinical Time Billing activity section.

2. From Service:

• If you would like to initiate the billing process while navigating a specific APCM service tab, you may begin billing by selecting the Start Billing icon at the top of the page and then following the instructions provided in the Billing flow.

  

  
  
• If you want to bill the records that are in the Billing section, then click the checkbox at the beginning of each record.

• You can see an "Add Bill" button on the Top Right of the table. Click on it to show a pop-up for adding a bill as follows.

• Service - The service name will be pre-populated based on the record you selected in billings.
• Note: If you select multiple records with different services, then it will be categorised as "others."
• CPT code: - Select the CPT code based on the billing type.
• Description - Based on the CPT code, you will receive some descriptors from which you can select.
• Note: If the desired descriptor is not available, scroll to the bottom of the dropdown, click on the other option, and enter your desired descriptor.
• Provider - The provider's name will be pre-populated based on the record you selected in billings.
• Patient - The patient's name will be pre-populated based on the record you selected in billings.
• From Date - It will be pre-populated, and the date and time will be based on the oldest record selected.
• To Date - It will be pre-populated, and the date and time will be based on the newest record selected.
• Notes - Add a note that is related to the billing.
• Call Type - It will be pre-populated when you select the CPT code. It is also editable.

After clicking on Add, the billed records will be disabled. The bill will reflect in the Claims tab.

• To submit your bill, please click the Bills Tab to navigate to the Bills section.

• When you navigate to the Bills tab, please select the service type in which you added the bill from clinical time.

  Note: If you have added a bill with services other than clinical time, please select the 'Others' tab in the service section of the billing.

Clinical Time Logging:

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• To view the Clinical Time Logging (Billing) for RTM, go to the Patient Dashboard and click on the Billing Tab. Following screen can be viewed.
• There are 4 sub tabs - RTM, RPM, CCM, Others and TCM, billing logs for each program. By default, RTM tab is active.Click on RTM tab.

Clicking on RTM, RPM, CCM, TCM and Others tab, will display calls list with checkboxes for each row with details as follows:

• CPT code
• Description
• Status
• Action

• Current Procedural Terminology (CPT) codes differ across all service types, including RTM, RPM, CCM, and TCM. As a result, the CPT codes used for each reimbursement type are not interchangeable.
• Billing period: You can view invoices on either a monthly or quarterly basis.

• When Monthly is selected, you can view the bills added in the selected month. When Quarterly is selected, you can view the bills added during that quarter.

• User can use the Add Row option to add a row in the given list with entering the details like Billing Type, CPT code, topic, Provider, Patient, Date, Start Time, End time, Meeting Notes and call type.
• Billing type, Provider, Patient and Date are auto-populated.

• To edit the call details, click the Edit icon in Action. This allows the user to update the details for the selected row in the list, including the CPT code, topic, Meeting Notes, and call type. Click the Update button to save your changes.

• You may view the new bills.

8. To submit your bill, select the checkbox. Once the submit buttons are enabled, click the Submit button.

1. User can select the calls from the list and click on Submit.
2. The submitted bills cannot be edited.
3. To see the bill updates, click on the Refresh icon beside the tabs at the left.
4. Each reimbursement type tab have filters as shown:

• All - Shows all the RTM call logs
• New - Displays all the newly submitted calls/ bills and are represented by Blue Color
• Submitted - Displays all the submitted calls/ bills and are represented by Light Green Color
• Rejected - Displays all the rejected calls and are represented by Red color
• On-Hold - Displays the calls which are kept on-hold and are represented by Amber Color
• Approved - Displays all the approved calls and are represented by Green color

On clicking the Rejected calls/bills, User can view the Rejected reasons, which shows the date with rejected reason.

YYou can also download the bill.

1. You can download the records document by clicking the download icon, which is located beside the delete option for each record.
2. You can download all selected records at once by clicking the “Download Supporting Documents” button, located at the top of the table.

Approve Time:

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• The call logs that are submitted are saved in the Billing Portal. Once the Admin logs in, they can view the screen shown below.
• By default, All Programs and All Providers are selected. You may adjust these options based on your preferences.

• On the dashboard, count for Patients enrolled, Patients billed, Bills accepted, Bills pending will be displayed.

• On the left-hand side, there is a table icon. Upon clicking on it, a pop-up will appear where you can select the required table columns, as shown below.

  

  

  
  
• There are 9 filters: Network, Center, Service, Provider, Claims Status, Payment Status, CTP Code, Duration, and Search Bills, which allow you to search bills for review.
• Users can filter the submitted billing list based on the bill status across four categories.
• Submitted Bills
• Bills on Hold
• Accepted Bills
• Rejected Bills
• Patients that qualify under the rules engine for the set of rules associated with the respective CPT code will be ready to be billed, while patients that do not qualify under those rules will be rejected by the rules engine.
• Users can also filter the submitted billing list based on the type of billing or product (All/RPM/CCM/RTM/TCM/PMPM).
• Click the Status filter, select the Submitted Bill option, then click the Program filter and select CCM. The following screen will be displayed.

• User can filter the submitted billing list based on the selected duration of Date from and Date to. We can view the bills based on the Duration type - Monthly, Quarterly & Custom. By default, we have Monthly selected.

  

• Users can filter the submitted billing list by provider name for the selected center.
• The search field is available on the dashboard to find the required data.
• Below the filters, the table is displayed with the following headers:
  • Checkbox — to select all records
  • Patient EMR ID
  • Patient Name
  • Date of Service — the date on which the service was provided
  • CPT Type — RPM/CCM/TCM/Other CPT code and topic
  • Note — meeting notes captured while scheduling
  • Provider Name
  • Bill details — Bill ID and the month, date, and year the billing was submitted
  • Actions — Approve / On Hold / Reject
• All submitted bills appear in the list in checkbox form. Users can select bulk actions to mark the selected bills as Approved or Rejected. Users can also download the bills by clicking the Download option.
• To submit the bills, select the checkbox and click Accept selected bills on the right. A pop-up will appear to confirm whether you want to accept the bill. Click Yes to accept the bill.

• You can also reject bulk bills by selecting the relevant records and clicking the "Reject selected claims" button. This button will be displayed in the header area once you select the bills. After you click the button, a pop-up window will appear prompting you to enter the reason for the rejection. Once you enter the reason, click Submit. The rejected bills will then be listed under Rejected Bills.

  
  

  

  
  

• You may perform actions—Approve, On Hold, or Reject—for individual calls. After the call log is approved, set to On Hold, or rejected, it will be categorized as Accepted, On Hold, or Rejected, respectively.

  

• If there are no calls logs, you will see an empty state showing No records found.

  

  
  
• Once the bills are accepted, you can view them by selecting Status as Accepted.
• To download the Bill report, select the checkbox for an individual record, or select the checkbox in the header to download the report for all records.
• You can download the report for any status, including All, Ready to bill, Submitted, On-Hold, Rejected, and Approved.

• You can view download option at the right, click on the download to download the report. You can view it in your downloads.

• We can also add the Billed Amount, Allowed Amount, Adjusted Amount, Balance Amount for each bill in the input field where you can enter the amount and click outside the field. It will be saved, but it is only for reference and will not be referenced anywhere else.

  

• We also provide the options Claim Denied, Claim Failed, Closed, Patient Pending, Secondary Pending, and Claims On Hold to update the payment status of each claim. To access these options, please select the submitted claim status and click the more icon, as shown in the image below.

• We also have the option to upload the billing reconciliation file. You can upload an Excel file with the claims data of each patient and check the history of the uploaded file. Additionally, you can download a sample file or sample reconciliation template by clicking on the "Download Reconciliation Template" button.

  

  

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