Remote patient monitoring (RPM) services involve medical observation of patients outside clinical settings through dedicated technologies. As a result, they require different billing procedures compared to that patient monitoring for admitted patients. Integration of relevant billing solutions for remote patient monitoring services is vital for healthcare organizations to be able to provide remote care services. As the medical industry adopts digital technology at an increasing rate, remote patient monitoring is bound to become more commonplace, resulting in an increasing need for RPM billing integration.
OSP enables medical organizations to provide healthcare services remotely by developing customized APIs to integrate RPM billing solutions. Our services will help to eliminate any financial barriers for providers to offer remote patient monitoring and care services. As a result, provider organizations can effectively expand access to care for people who might not require in-person clinical visits.
OSP’s solutions for RPM billing will ensure HIPAA compliance by securing patients’ medical and billing information. Our solutions will be tested thoroughly against established standards to prevent any data leakage or loss of integrity. Incorporating a billing solution into existing health systems and RPM platforms can also establish access controls and audit trails as additional layers of security.
When healthcare provider organizations can be certain of steady revenue cycles, they can provide reliable services to their patients. The incorporation of a system for remote patient monitoring billing goes on to serve all the stakeholders – the providers, payers, and the patients in the long run. Providers can focus their time and resources on caring for patients without worrying about revenue cycles.
We’ve reached out and found companies like OSP to create our technology. This is my first time working with a company that has been so thorough. These guys are amazing. If you really are looking for someone for a technology solution, these guys are the real deal.-- Stephen Carter
We reached out to OSP to provide an estimate on a technology solution we were interested in developing. From the initial conversation, the team was professional, courteous, and thorough. We were able to make a quick decision to move forward with OSP because we were confident that our requirements were accurately captured and the development deliverables and associated costs were clear.
The OSP development team stayed on schedule and within budget throughout the build phase and provided weekly communications to keep our team informed along the way. If we require application development in the future, OSP will be the first call we make.-- Selita Jansen
We have worked closely with OSP for two years, meeting twice a week to work through development requirements, strategy, design, progress, and support. OSP has become an integral part of our business, and our mutual teams work together as one team. OSP tackles problems that arise with integrity and operate with respect for budgeting.-- Charlie Langdon
Yes, I would certainly recommend their services because they were diligent and the offered price was very reasonable which is a challenge these days to get a great product at excellent pricing.-- Bert Lurch
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RPM (remote patient monitoring) is a subcategory of telehealth where providers can monitor patients’ health outside conventional clinical settings. This is accomplished using medical devices alongside digital and telecommunications technologies.
When it comes to RPM billing, it involves providers billing for services they provide remotely for patients who avail of RPM and associated services. After doctors provide the RPM services, they are coded, and claims are generated. The out-of-pocket payments are collected from patients online, while the rest may be obtained as reimbursement from payers.
Remote patient monitoring services can be billed by any billing physician, qualified healthcare professional (QHCP), or clinical personnel under CPT Code 99457. This code requires at least 20 minutes of virtual medical services to the patient.
CPT Code 99453: It is used for reporting the setting-up and education of patients on using the RPM devices. It is mostly used once per patient when the RPM services begin.
CPT Code 99454: This code is used for reimbursement for the supply of remote monitoring devices and observation of patient data. The patient readings must be taken at least 16 days every month.
CPT Code 99457: This code reports the time spent by a clinical professional in interactive communication with a patient for remote monitoring services. It needs at least 20 minutes logged for the code to be applicable.
CPT Code 99458: This is an add-on code to 99457. It is used for an additional 20 minutes after the initial 20 minutes for the previous code. It can be billed in unlimited 20-minute increments each month.
CPT Code 99091: Medical data is saved digitally and communicated by the patient or caregiver to a physician or other qualified healthcare professional (QHCP). It needs to be done for 30 minutes every 30 days.
RPM, or remote patient monitoring, uses multiple devices to gather patient information. These are then relayed to the providers using varying technologies and data formats. So, it is important to ensure data security since the risk of data loss is increased because of the disparate nature of RPM services.
Providers need to acquaint themselves with the reimbursement options in their practicing locations. This is because different payers would have different regulations or policies concerning RPM, and any oversight would cost providers their reimbursements.
Providers must ensure that all the devices used for remote patient monitoring comply with regulations. Since the regulations might evolve, it is important to ensure the companies building them follow compliant procedures.
When providers doubt a patient’s condition based on vital signs taken from RPM devices, it is best to bring them in for an in-person visit. Various factors might be missed during remote monitoring, and seeing a patient physically would help providers better understand the patient’s condition.
The CMS guidelines for RPM medical billing require providers to have a minimum number of face-to-face interactions, report data periodically, and for the providers to be qualified medical professionals. Providers include the appropriate codes in their claims to indicate their services.
HIPAA regulations require RPM services to ensure an adequate amount of data security, data privacy, and data integrity. Providers offering remote patient monitoring services must use medical devices from companies that employ compliant practices and ensure their devices comply with HIPAA.
CPT Code: 99453 – For remote monitoring of physiologic parameters, including the initial setup and patient education on device use.
CPT Code: 99454 – For monthly remote monitoring of physiologic parameters and the supply of the devices for patients.
CPT Code: 99457 – For billing 20 minutes of interactive virtual care every month by a qualified healthcare professional.
CPT Code: 99458 – This is used as an add-on with the 99547 for additional time blocks on top of the initial 20 minutes.
Billing in remote patient monitoring involves providers using the appropriate CPT codes to file for reimbursements. It is for medical services provided as part of an RPM program.
A patient suffering from a chronic disease requires RPM services. He is prescribed a remote monitoring program that requires monitoring his blood pressure, heart rate, weight, and blood glucose levels. After sending his health vitals, the patient begins the program and communicates with his doctor.
In this case, the provider can use the 99453 for the initial setup and 99454 for each month the patient transmits data. It has to happen for at least 16 days each month for the 99454 to be applicable. Moreover, if the patient requests virtual care, the provider can use the 99457 for 20 minutes of virtual interactive communication to offer medical services.