Remote care has become an established, convenient way for providers to monitor patients in between office visits. And as we move on from the worst of COVID-19, the lessons learned from the pandemic include a powerful truth: virtual care, once considered just a temporary innovation, is here to stay.

Providers are learning that their patients don’t just want Virtual Care Services (VCS); they expect them, especially Medicare-eligible seniors who may struggle to make arrangements for frequent trips to the doctor or forget to take critical medications at home. These challenges contribute to increased costs for patients, providers and healthcare systems.

CMS is committed to help reduce healthcare costs and improve coordination of care for Medicare-eligible patients. It created permanent CPT codes that allow for reimbursement of basic clinical services rendered remotely through programs such as Chronic Care Management and Remote Patient Monitoring. Most practices don’t have the bandwidth to successfully implement these valuable programs internally, so CMS allows every element of remote care programs to be outsourced and still be reimbursable.

The most practical method for this outsourcing of remote care needs is to enlist an established third party with the experience and clinical and administrative bandwidth to handle every part of the VCS process.

HealthXL® knows virtual care better than anyone, having been at it since 2015 and has applied its expertise to help providers implement remote care programs. We provide end-to-end services that improve access to care, reduce healthcare costs and provide an additional revenue stream with no upfront costs to the practice. HealthXL® is an expert provider in managing all aspects of CCM and RPM services, such as:

Enrollment: Older patients are often resistant to change and may not understand the benefits of what you’re offering, even when it’s clearly in the best interest of their long-term wellness. If you can’t make them see what remote care can do for them, your program will struggle.

Device management: Reliable blood pressure cuffs and pulse oximeters (for instance) can be hard to find, and harder still to deliver to patients in a cost-effective way. An experienced vendor has spent years developing relationships with suppliers and is always looking for innovations in device accuracy and reliability.

Patient outreach: CMS has stringent monthly requirements for contacting patients and recording vitals readings. What’s more, the clinicians who speak to them need to be encouraging, inquisitive and persistent, understanding that every patient has unique needs.

HIPAA compliance: Safely recording, storing and accessing patient data requires a software platform that evolves with changes in the regulatory landscape and in your patient population.

There are numerous reimbursable CMS programs, but we focus on two:

Remote Patient Monitoring (RPM) is based on three CPT codes (99453, 99454 and 99457), and requires patients to transmit vitals data (blood pressure and weight, for instance) at least 16 times per month and for clinicians to provide at least 20 minutes of treatment for each patient, comprised of phone time and updating care plans.

Chronic Care Management (CCM) is based on CPT code 99490 and requires a patient to have at least two chronic conditions (such as hypertension or COPD). This service doesn’t involve vitals readings but does require 20 minutes of clinical staff time monthly per patient, just like RPM.

There’s simply no substitute for HealthXL’s proven approach to Virtual Care Services, no matter the size, scope or specialty of your practice. Contact us today and we’ll partner with you to customize a profitable, sustainable solution for your unique needs.