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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• One should have at least one chronic condition
• Should have an active insurance
• And, should be 18 years and above

CPT Rates:

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1. There are five CPT codes for RTM.
2. Below are the details of these CPT codes with their rates.

Instructions:

1. Click on the RTM tab on the patient dashboard

As you can see an accordion on top, it can be expanded and closed when needed. By default, the patient details accordion will be closed.

And, once when clicked on the expand button, you can see the expanded Patient details as follows.

On the left, you can also view a call icon beside the Mobile, that is used to call the patient on his cell.

1. Click on “Add RTM episode” to enter into “Consent” tab.
2. You will see a wizard at the top, which has the following sections:

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

Consent:

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1. If the patient agrees to take RPM service, click on "Accepted by patient" and submit.

1. The Consent can be viewed in two Languages - English and Spanish.
2. By default, we have English language selected. Below is Consent screen in Spanish.
3. If the patient disagrees, then click on "Rejected by patient" and submit. This can be later edited.
4. Accept consent and click on “Next” to enter “Chronic Diseases” tab.

Add RTM:

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1. After submitting the consent, Chronic Diseases section appears. You can navigate to any section after the consent is submitted.

2. You can add chronic diseases by clicking on the "Add" button beside the label. A Chronic Care Problems pop-up will appear. Search for the condition by clicking the Search button. Fill in the other details and click on the "Save" button. Click on the "Cancel" button to cancel adding the chronic disease.

3. You can add allergy diseases by clicking on the "Add" button beside the label. A pop-up for allergies will appear. You need to select the allergy name from the dropdown list and provide the severity based on your condition. Also, include the date recorded and the status of the allergy. Fill in the other details and click on the "Save" button. Click on the "Cancel" button to abort adding the allergies.

4. You can see the list of Active Medications prescribed for the patient below the allergys. You can add, edit, activate & inactivate, and delete medicines.
5. To add medicines, click on "Add Medicine" Button on the right. Add Medication Pop-up appears. To get prescription expiry reminder, check the box and select any of the two options - Remind before 5 days or 10 days and click on "Add Prescription" Button to save and add Prescription.

1. To edit any medicine, click on the respective Edit buttons. Upon clicking Edit button, Update Prescription pop-up appears, make the changes you want to update and click on Update Button.
2. To inactivate any medicine, switch the toggle to OFF state, the medicine will be inactivated.
3. To activate the medication, switch the toggle to the "ON" state. Then a pop-up will open, and you need to select the date until when you would like to make the medication active then click update.

1. When you click "Next," you will navigate to the device details tab.

2. The Devices section is divided into two subsections: Assign Details and Order Details.

   
   

Assigns Details

If a patient does not have any devices assigned, the Assign Details section will show an empty state. To assign a new device, click Assign Device. A pop-up will appear where you can 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 assign the device.

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.

After filling out the form, click Submit. The order will be added as a new record in the table. You can view the order details by clicking the eye icon, which will open a sliding window.

Ordering Supplies:

If a device requires supplies, you can order them by entering the desired quantity and clicking the +Order Supplies button located above the table. The supplies will be shipped to the same address used for the device order. Once the order is successful, a record for the supplies will appear in the table.

After you update the devices, click "Next" to proceed to the Data Monitoring section.

1. In this tab, if there are no readings, then we will see an empty state as follows:
2. You will see the pill box readings, which are divided 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.

7. Once you view the Data Monitoring, click on the Next Button. Interaction Screen appears.
8. Here, all the patient, Medical Assistant interactions will be recorded. Click on "Add Claims" Button to add an interaction. You can view pop-up as follows:

9. Fill the details and click on the "Add Button". You can view it in the list as follows:

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.
• From - select the from time.
• To - select the to time.
• 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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1. After adding RTM, You have the ability to update Chronic Diseases/Allergies by hovering over the Conditions. Two actions are available - Edit and Delete. Clicking the edit icon will display a pop-up for making updates in the Conditions as follows:

2. On clicking the icon, Chronic Care Problems pop-up opens as follows:

3. You cannot update the condition; only the condition details. Make sure to add the Condition Status as well.
4. When it comes to editing/updating allergies, you can edit any fields in the pop-up.

5. After you can make your updates, click on the "Update" button, click "cancel" to discard the changes.
6. While coming to the medication you cant be able too edit the medication related data. but you can edit only the time and the refill reminders.

7. When moving to the next section, you can edit the device by clicking on the Edit icon of the device record. You can delete the device by clicking on the Delete icon. After making your changes, click on the update button.

8. You can view all the reported pill box readings here.
9. You can click on the refresh icon to refresh the section and view any other generated pill box readings.

10. Your changes will get updated. You can navigate between these sections by Previous and Next Navigation Buttons at the bottom.
11. In interactions, you can click on the Edit icon, to update the Bill details.

12. On clicking the Edit icon, you can view the pop-up as follows:

13. After you make changes, click on the Update Button.
14. The RTM History can be accessed on the right-hand side by clicking the button. Upon clicking the button, a small overlay will appear, displaying the history of the service as shown below.

Discontinue RTM:

We can also discontinue the RTM episode by clicking on the Discontinue Service button, which is next to the RTM History button on the top right-hand side. Upon clicking on that, you will get a pop-up modal where you will find a text box. Here, you have to provide a reason for the discontinuation.

Once the service is discontinued, you can add, edit, or delete any chronic diseases, devices, data monitoring, and interactions.

Resume RTM Service:

1. If you are willing to resume the service, then click on the Resume Service Button, which is next to the RTM History button on the top right-hand side.

   Once you click on "Resume Service," you will navigate to the consent page where you should accept the consent in order to resume the service. Once the service is resumed, you will receive the old data and be able to take actions to add, edit, or delete the data.

   

   

   

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

   There are multiple ways to add a bill.

   1. From Patient Listing.
   2. From Patient Dashboard.

   3. Manual Log Entry From Clinical Time.

      
      

2. From Patient Listing.

• As shown in the above image, when you click on any service RTM in the patient listing, it will show you the pop-up as follows.

  

  If you click on Yes, the timer will start (billing time will begin) and you will navigate to that service in the patient dashboard. If you click No, you will navigate to that particular service in the dashboard without billing.

  Billing Flow

• If you have clicked on the APCM service and then clicked on Yes to bill the time, it will navigate you to the service with the billing timer ON. This action will disable other services because when you are billing for a particular service, you can't navigate to other services such as CCM, PCM, TCM, RPM, or AWV.

  

If you want to stop the billing, you can click on the STOP icon at the top near the header as follows.

Once you STOP the billing, the other services will be enabled, and the bill will be reflected in the clinical time billing activity section.

2. From Service:

• If you wish to initiate the billing process while navigating a specific APCM service tab, you can seamlessly commence billing by selecting the Start Billing icon located at the top and proceeding with the instructions outlined 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.

1. To submit the bill, click on the Bills Tab to navigate to the Bills section.

• Upon navigating to the Bills tab, select the service type in which you have 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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1. 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.
2. 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.

1. 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

1. CPT codes are different for all types i.e., RTM, RPM, CCM, and TCM. CPT codes for all reimbursement types are different.
2. Billing Period- We have options to view the Bills - Monthly and Quarterly.

3. When Monthly is selected, we can view the bills that were added in the selected Month. And, when Quarterly is selected, we can view the bills that were added in that Quarter.

4. 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.
5. Billing type, Provider, Patient and Date are auto-populated.

6. To edit the call details click on the Edit icon in Action, allows user to edit the details like CPT code, topic, Meeting Notes, call type for selected row in the list. Click on the update button to save changes.

7. You can view the New bills.

8. To submit bill, check the box, you can view the submit buttons gets enabled. Click on 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.

You can also, download the bill.

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

Approve Time:

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1. The calls logs that are being submitted are saved in the Billing Portal. When the Admin logs in he can view the following screen.
2. By default, we have All Programs and All Providers selected. You can change it based on your preferences.

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

4. 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.

   

   

5. There are 5 filters - Status, Program, and Provider, Duration and Search Bills, using which we can search the bills to review.
6. User can filter the submitted billing list based on the Status of the bill in 4 categories.

• Submitted Bills
• Bills on Hold
• Accepted bills
• Rejected bills

7. Patients which are qualified by rules engine for the set of rules mentioned for respective CPT code, will be ready to Bill and patients which do not qualify the set of rules mentioned are rejected by rules engine.
8. User can filter the submitted billing list based on the type of billing or product (All/RTM/RPM/CCM/RTM/TCM/PMPM)
9. Click on the Status filter and select Submitted Bill option and Program filter and select CCM . The following screen can be seen.

10. 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 or Quarterly, by default, we have Monthly selected.

1. User can filter the submitted billing list based on the provider name for the specific center.
2. Search field will be available to search the required data on the dashboard.
3. Below the filters, we can see the table with following headers:

• Checkbox - To select all the records
• Patient EMR ID
• Patient Name
• Date of Service ( Date on which the service was provided)
• CPT Type (RTM/RPM/CCM/TCM/Others CPT code and Topic)
• Note (Meeting Notes while scheduling)
• Provider Name
• Bill details (Bill ID and Month Date, Year on which billing was submitted )
• Actions (Approve /On Hold /Reject)

11. All the submitted bills in the list, in the checkbox form, user can select the bulk actions to mark the selected bills as Approved or Rejected. And also can download the bills by clicking on the Download option.
12. Click on the checkbox and click on the Accept selected bills at the right, to submit the bills. You will view a pop-up to confirm if you want to accept the bill or not. Click on Yes to accept the bill.

13. We can also reject bulk bills by selecting the records and clicking on the "Reject selected claims" button, which will be visible in the headers once you select the bills. Upon clicking the button, a pop-up will appear where you have to enter the reason for rejecting the bills and click submit. The bills will then be seen under rejected bills.

14. You can perform actions - Approve, On Hold and Reject for individual calls. After the call log is being Approved/ is On Hold / Rejected. Those call logs will be categorised into Accepted/Rejected/On Hold respectively.

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

1. After the bills are accepted, we can view them by selecting the Status as Accepted.
2. Here, to download the Bill report, check the box for an individual record or check the box in the header to download report for all the reports.
3. We can download the report w.r.t any Status - All, Ready to bill, Submitted, On-Hold, Rejected and Approved.

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

2. 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.

   

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

   

   
   

4. 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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