General RPM and CCM Questions

The following are Frequently Asked Questions about the Remote Patient Monitoring (RPM) industry in general:

  • What is Remote Patient Monitoring?

    Remote Patient (or Physiologic) Monitoring uses cellular-enabled home scales, blood-pressure monitors, SpO2 and blood glucose monitors to measure, transmit and record physician-ordered measurements. This is augmented by nurse call center conversations, all of which are then uploaded into your office EHR system or faxed to you. The goal is to prevent patient conditions from worsening and reduce ER visits or hospital admissions. At the same time, physicians can experience substantial financial improvements from RPM income.

  • What patient conditions are served by RPM?

    A number of conditions/diseases can be managed using RPM; however, the most common are previously unmanaged or poorly managed Hypertension, CAD, CHF, COPD and Diabetes. A specific diagnosis is not required to enroll a patient in RPM.

  • What is CCM?

    Chronic Care Management is a CMS-approved program, in which qualified clinical staff call and talk to your patients at least 20 minutes per month to review the behaviors, actions, symptoms and compliance of co-morbid, at-risk patients. The goal is to prevent the acute onset of symptoms and avoid preventable hospital admissions.

  • What patient conditions are served by CCM?

    CCM patients must have at least two chronic conditions that put them at substantial risk of death, decline or decompensation. A partial list includes CKD, Depression, DM, CHF, Hyperlipidemia, HTN, AMI, Ischemic Heart Disease, TIA/Stroke, Cancer, Asthma, Dementia, Hypothyroidism and Arthritis.

  • What does a Remote Patient Monitoring service do?

    Each RPM servicing company defines its own scope of services. However, RPM companies typically provide hardware, software, monitoring and documentation capabilities to allow physicians and other recognized ordering providers to oversee trended physiologic data, specifically targeting a given patient’s care. Outsourcing saves the provider time, cost and staffing that would otherwise be required to deliver this granular provision of services.

  • How does Telehealth (Telemedicine) differ from Remote Patient Monitoring?

    Telehealth is a virtual 1:1 visit between a patient and physician/provider using real-time audio-video, in lieu of an in-person encounter, to address “almost any” health matter at any point in time. In contrast, RPM is a process of proactively monitoring a patient’s key physiological measures over time, for a specific condition or disease, to allow adjustment of medications, behaviors or other physician directions. This helps keep patients from worsening or becoming acutely ill to the point of requiring hospital admission.

  • What devices are used for Remote Patient Monitoring?

    RPM devices are cellular- or WiFi-enabled physiologic measurement tools, just like those used for home or ambulatory diagnosis, which are programmed to send results instantly upon completion to a designated computer system designed for tracking, reporting and documenting a patient’s status or condition.

  • What services are provided by the RPM nursing service (or call) center?

    DisSante Health’s nursing call center staff reviews all patient downloaded results and acts according to the direction of each ordering physician’s guidelines, via an algorithm tied to the RPM software. Per CMS requirements, the nurses are responsible for contacting all enrolled patients for a minimum of 20 minutes a month to review their physician’s care plan and how they are doing with medical and other therapies in relation to the trended monitored results.

  • What are the requirements for enrolling a patient in Remote Patient Monitoring?

    Initially, CMS required a specific ICD-10 diagnosis to enroll patients in RPM. However, in 2020, this requirement was eliminated. Now, the only requirement is that the patient has a disease or condition that, in the physician’s professional opinion, puts them at risk of death, or substantial worsening of their condition, which would likely lead to hospitalization or acute intervention.

  • How does the physician/practice get paid?

    DiaSante Health will document all required aspects of the billing process. Our service center will upload all documentation once per each 30-day billing cycle, including our expert-recommended CPT codes, as substantiated by each month’s activity, from among the following list of CMS-approved codes: 99091, 99453, 99454, 99457 and 99458. There are initial setup and education charges and monthly monitoring and provider care oversight charge(s). Typically, 3-4 CPT codes are billed, depending on scope and time. The physician/group’s normal Revenue Cycle Process will upload, bill, collect and post the charges and payments per your existing practice billing process.

DiaSante Questions

The following are Frequently Asked Questions about DiaSante specifically and the services we offer:

  • What if we don’t have the capacity to monitor our patients? Does DiaSante Health provide a monitoring service?

    Yes, DiaSante Health’s nursing service center provides turnkey, non-emergent device monitoring from 8 am to 5 pm, Monday through Friday. Note that RPM monitoring is for chronic conditions and is not intended to provide emergency monitoring or ambulance dispatch services.

  • Can DiaSante Health data integrate with our EHR/EMR?

    DiaSante Health will work with each enrolled physician or practice to determine the best and most effective way to upload the monitored results and nursing progress notes into the ordering physician’s EHR and/or Practice Management billing system. Fully automated integration is possible, but for smaller groups, the most cost-effective process is to allow our nurses access to your EHR system. All documentation will be saved to a .pdf format and uploaded to the location of choice.

  • How is our clinic invoiced by DiaSante Health?

    DiaSante Health will reconcile the actively enrolled patients based on a 30-day billing cycle. Patients meeting CMS RPM payment criteria (volume of tests and minutes of patient contact) will be uploaded into the practice’s billing system. DiaSante Health will concurrently invoice the practice for our services, using a standard invoice sent to your Accounts Payable department, based on the contractually agreed-upon rates and payment terms.

  • What is an example of synchronous communication, and how do you track it?

    Synchronous communication is defined as “real-time two-way communication, using audio or audio/video technology to talk with a patient.” Examples include telephone, FaceTime, Zoom, Skype or similar applications where the two individuals are directly connected to one another allowing an immediate transmit-response cycle. Our proprietary RPM platform integrates with the telephone or computer system to track calls as they occur, and the call start/stop/duration times are captured in the notes that are subsequently uploaded into the physician’s billing system.

  • What is an example of asynchronous communication, and how do you track it?

    Asynchronous communication is any other non-real-time process, such as email, voicemail, chat or “bot-enabled” communication. These modes of communication do not meet CMS billing criteria and are not calculated into the 20-minute minimum call log. DiaSante Health will document asynchronous communication, if necessary, to try and establish synchronous calls, or as call/monitor testing reminders.

  • What is the difference between a cellular and Bluetooth device?

    RPM technology has evolved since its initial inception. While several options remain available, DiaSante Health uses cellular-enabled devices. A cellular device has its own embedded sim-card and number, allowing the device to “call” DiaSante Health’s RPM system to report its own test results immediately upon completion of each test. Bluetooth uses short-distance transmissions to download the test results into a “base unit” in the patient’s home, which then transmits the results to an RPM platform via the internet. Based on limited bandwidth and internet availability in many rural areas, this can be a substantial barrier to enrollment or participation for many patients, hence, DiaSante Health’s decision to use cellular technology.

  • What types of devices can I use with DiaSante Health?

    The four devices currently available are weight scales (typically for CHF sudden weight gain), blood pressure cuffs (typically for poorly managed hypertension), SpO2 pulse oximeters for COPD or post-Covid-19 conditions, and blood-glucose monitors for Diabetes. Of course, those same measures can be used for other diagnostic purposes, as determined by the ordering physician. Other devices are in the beta testing stage, including a wearable heart rhythm device that could be used to monitor sinus rhythm versus arrhythmic conditions, such as A-Fib/A-flutter. There are additional tools in development for future use.

  • Are the devices included in the program?

    DiaSante Health provides the devices as part of our RPM enrollment program. The cost of each device runs from $150 to $200, depending on the specific device. To fairly compensate for this up-front cost, DiaSante Health will charge the physician 100% of billed charges until the device is paid for, typically two months, after which the “regular” shared revenue model begins.

Patient RPM Questions

The following are common Frequently Asked Questions patients have about Remote Patient Monitoring:

  • What is the meaning of Remote Patient Monitoring?

    Remote Patient (or Physiologic) Monitoring, frequently shortened to “RPM,” is simply a service where your doctor is able to measure your vitals while you are at home. These measurements are combined with regular calls from a nurse, who will discuss actions that relate to your health. Your doctor will view these key indicators of health, including weight, blood pressure, blood oxygen, blood sugar, and possibly heart rhythm and pharmaceutical medication adherence. By acting on these indications early, your doctor can often prevent unnecessary trips to the emergency room or hospital admissions.

  • What are the benefits of Remote Patient Monitoring?

    Essentially, RPM provides an extra set of eyes on your key health markers and allows early action to prevent you from becoming acutely ill. RPM also ensures you have a trained professional to talk with regularly, answer your questions and partner with you to maintain your health. Many of these RPM measurements can be seen and acted on well before you feel worse. We call this “proactive” disease management because we can reverse the problem before it causes you substantial pain or illness.

  • What is an example of Remote Patient Monitoring?

    A frequent example would be: You put on a wrist blood pressure cuff, press the “Start” button and as soon as the blood pressure is indicated on your screen, those numbers are sent by the device to the RPM nursing support center’s database. The nurses will watch your trended data over time and make recommendations on how to improve your blood pressure, as directed by your doctor. The same process is used for all conditions and those related measurements.

  • What is the difference between Remote Patient Monitoring and Telehealth?

    RPM is a specified process to monitor specific physical measurements, aligned with nurse communications, intended to prevent the worsening of a relatively small group of conditions/diseases. On the other hand, Telehealth (or Telemedicine) is a very broad method of using audio/video technology (such as Zoom, special telehealth software or “Apps”) to conduct a traditional patient office visit remotely. Telehealth is just another way of conducting an examination, but the doctor can really only see and speak to you and can’t touch you, so the “examination” part is thus limited.

  • What does a Remote Patient Monitoring nurse do?

    The RPM nurse is the doctor’s representative in helping keep you healthy. As required by Medicare or your insurance company, the nurses are required to speak with each patient for a minimum of 20 minutes per month. Most of these conversations are about your symptoms and what you can do to maintain your health. With the stated goal of keeping you out of the hospital, the nurse will monitor your remote measurements and suggest actions, as directed by your doctor. These actions could be dietary, medical or behavioral; but they are all under the specific guidance and supervision of your doctor depending on your condition or diagnosis.

  • How is Remote Patient Monitoring done?

    Each device is cellular enabled with its own data plan. Your operation of the device is the same as any other non-RPM device that measures weight, blood pressure, SpO2 or blood sugar/glucose — it’s completely transparent to you as the user. The software tracks your scores over time and the nurses use those scores to make notations, as directed by your doctor. The system uploads your scores and nursing notes into your doctor’s in-office electronic health record (EHR), so they can be discussed during your next regular office visit.

  • Why is Remote Patient Monitoring important?

    Unanticipated trips to the emergency room and avoidable hospitalizations are inconvenient, uncomfortable, expensive, and can expose patients to additional risks. The conditions monitored and helped by RPM frequently lead to such hospital/ER trips if left untreated. RPM is a cheap and convenient way for you and your doctor to proactively keep you healthy and out of the hospital.

  • Who qualifies for Remote Patient Monitoring?

    Any patient with a diagnosed condition or disease that your doctor feels would benefit from RPM can officially qualify. Medicare covers all RPM services and commercial health insurance frequently will do so as well, but they must be pre-authorized. It’s also important to know in advance if copays are required and where RPM falls related to your annual deductible. The majority of RPM patients are in the following categories:

    • Weight: for Congestive Heart Failure (CHF) or a recognized weight management program
    • Blood Pressure: for poorly managed or unmanaged Hypertension (high blood pressure) or Cardiovascular Disease
    • Blood Oxygen or SpO2: for Chronic Obstructive Pulmonary Disease (COPD) or Emphysema
    • Blood Sugar or Glucose: for Diabetes Mellitus (DM)
    • Heart Rhythm: for Atrial Fibrillation, Flutter, Palpitations or other Arrhythmic conditions
  • Who needs Remote Patient Monitoring?

    Any patient with one of the above-listed conditions and whom the managing physician feels is at risk of worsening health, or at risk of losing life or limb, is a good candidate for RPM. While a primary goal is the prevention of unnecessary hospitalization, the same actions maintain your overall health and reduce the risk of your condition getting worse or can slow down the progression of the disease.

  • How do I start Remote Patient Monitoring?

    Ask your primary care physician if you would benefit from RPM services and if the doctor would consider ordering RPM for you. The above list of conditions is not exclusive. If your doctor feels you would be a good candidate based on your diagnosis, then RPM can be ordered for you.