What is the eDoc RPM Program?
The eDoc RPM Program is actually three healthcare programs in one. All are considered Telehealth programs by CMS with two of the three specifically designed to support Chronic Care Management services (CCM) and Remote Patient Monitoring (RPM).
The Centers for Medicare and Medicaid Services (CMS) revamped their previous Chronic Care Management Program and Remote Patient Monitoring programs with the addition of seven new billing codes. Starting in 2020, CMS also redefined who could administer clinical support services associated with both of these two programs thus allowing a billing physician to contract to a 3rd party technical medical services organization under the “general supervision” of the billing physician to provide such services.
Global Care International took advantage of these new changes and developed a universal EMR Class Dashboard from which to manage all three of these programs using four digital health solutions. Collectively, the total solution achieves and exceeds all elements of the much sought after “Triple Aim”!
Others May Claim to Do RPM, But Global Care International Does It Right!
As Much as We’re About the Data, We’re Also About the Numbers. Let’s Take a Look!
Example of the adoption and usage by providers of the CCM Program using statistics as compiled and reported by CMS:
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Annual number of unique patients (U.S. average per family medicine provider)3,279
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Percent of patients covered by Medicare (US average: 21.85%)21.85%
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Annual number of unique Medicare patients716
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Percent of patients with 2+ chronic conditions (U.S. average 68.6%)68.6%
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Annual number of unique CCM patients491
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CPT 99490 monthly Medicare Allowed Reimbursement (U.S. Average)$39.13
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Estimate annual CCM reimbursement for family medicine provider$192,128 Gross
Note: The Above Example Represents the Average Number of Provider Patients With 2+ Chronic Conditions
“The RPM Program Patient Enrollment Requirements Are
Only One Acute or Chronic Condition !!!
“
Overview of the Remote Patient Monitoring Program
- CPT 99453 – Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.
- CPT 99454 – Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.
- CPT 99457 – Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes.
- CPT 99458 – Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; each additional 20 minutes of service time for a total of 60 minutes per month counting CPT 99457.
Projected New Revenues From Existing Patient Populations with at least One “Acute/Chronic Condition”
Capable of generating between $150k to $300k “Net” Annually
(Based on 250-500 Patients Enrolled)
Global Care International would provide and be responsible for handling:
- The supply, delivery and support services for all FDA Approved Medical Devices to the individual Patient enrolled in the program
- 24/7/365 Monitoring and Response to all patients enrolled in program by way of a Registered Nurse Case Manager assigned to the billing physician and/or the practice with ongoing communications and reporting using the eDoc-on-Call Telehealth EMR Portal and accompanying Dashboard with the Ordering Physician and their clinical staff
- Submission of Monthly Billing and supporting activity logs for each patient enrolled in the program to the Ordering Physician for submission of claims to CMS or direct billing services provider on contract to the billing physician or their practice.
Overview of the Chronic Care Management Program
- G0506 – Comprehensive assessment of and care planning for patients requiring chronic care management services. List separately in addition to primary monthly care management service codes; 99202-99205, 99212-99215, 99217-99220, 99221-99223, 99224-99226, 99231-99233, 99234-99238, 99281-99285, 99304-99310, 99315, 99318, 99324-99337, 99341-99350, 99483, 99495, 99496, G0402, G0438, G0439
- CPT 99490 – Chronic Care Management services, at least 20 minutes of clinical staff time under the general supervision of a physician or other qualified health care professional, per calendar month.
- CPT 99439 – Chronic Care Management Non-Complex Add-on Code for an additional 20 Minutes of Non-complex CCM services after fulfilling requirements associated with CPT 99490. This Code may be billed up to 2X per month.
Projected New Revenues From Existing Patient Populations with at least two or more chronic conditions
Capable of generating between $100k to $200k “Net” Annually
(Based on 250-500 Patients Enrolled)
Global Care International would provide and be responsible for handling:
- All direct communications and overall management of patients enrolled in the program to include documenting all activities to include communications with patient into the medical records system in compliance to all CMS requirements involving the Comprehensive Care Plan component of the program. (Seven components)
- 24/7/365 Access and Response to all patients enrolled in program by way of a Registered Nurse Case Manager assigned to the billing physician and/or the practice with ongoing communications and reporting using the eDoc-on-Call Telehealth EMR Portal and accompanying Dashboard with the Ordering Physician and their clinical staff
- Submission of Monthly Billing and supporting activity logs for each patient enrolled in the program to the Ordering Physician for submission of claims to CMS or direct billing services provider on contract to the billing physician or their practice.
Unique Capabilities of the eDoc-on-call EMR and Cloud-based Telehealth/CCM & RPM Dashboard
- Ability to establish thresholds (Frequency, Minimum, Maximum Values) of all medical device’s parameters by individual.
- Ability to establish and set automated Notification of Alert Message for any adverse alert triggered by the thresholds.
- Ability to establish and trigger a wide variety of Assessment Questionnaires for any of the 22 recognized Chronic Care Conditions as established by CMS for transmission to the patient via Email, Text and Direct Visual using the Home eHealth Monitoring System (PC/IOS/Android).
- Ability to establish automated transmission(s) of Patient Education Materials from a ‘built-in library’ to the patient relative to unique clinical conditions.
- Ability to display/manage/evaluate (AI) the patients longitudinal medical history including their physiological data in real time.
- Ability to connect all of the Patients Healthcare Team on the status of the Patients status, progress and overall well being.
- Automatic transmission of Clinical Encounters Summaries to all care providers of record for a given patient in an CCDA format suitable for direct ingestion to every Certified EHR.
“If you’re interested in learning more about the Global Care International Program, let us know by clicking on the get a free consultation. In 30 minutes or less, we can explain the program and even give you quick demo. Other people may do CCM and/or RPM, Global Care International Does It Right”
What Does this Solution Consist of and What Can It Do?
This Total turn-key solution consists but of three major components; a Personal Health Records solution called My Records Now, a physician’s Telehealth/Telemedicine based EMR called ICMyDoctor and a cloud based local or remotely manned by clinical staff Telehealth, CCM & RPM web application appropriately called Comprehensive Virtual Care EMR. For a high-level 50,000-foot view of the system capabilities, I give you the following:
My Records Now Personal Health Records cloud-based system.
This patient facing Personal Health Records system as provided to all patients enrolled in a physician-based Telehealth, Remote Patient Monitoring or Chronic Care Management Program is capable of consolidating a patient’s medical records from every certified EHR in North America. Once the records are downloaded from any Patient Portal, they can be uploaded to the My record Now Platform where they are parsed, normalized, and reconciled into one “Unified Longitudinal Medical record”.
See www.myrecordsnow.com
“The sole purpose for this solution was to ensure that every physician with whom the patient ever presents to in any fashion, is afforded every piece of medical history data on the patient, absent not one piece, that if known, would have changed or altered their resulting diagnosis and treatment of care. If medicine is a science, then the science is the data, absent such, we are forever more doomed to only practice medicine”. Robert E. Higgs – Founder/CEO of Global Care International.
ICMyDoctor Telehealth Encounter Consult cloud-based EMR.
This physician facing solution was developed in support of Telemedicine and Telehealth. It supports both Store & forward and Interactive Video Consultation Medical Encounters between a physician and a patient. Much like an EHR provides a rich medical data collection and aggregation system to include robust decision support, this cloud-based system was designed to capable of being used as a stand-alone system with the ability to export data back into every Certified EHR in North America. The system includes the following features: (Abbreviated Listing)
- My Encounter Consults – Manages both Telehealth, Chronic Care Management and Remote Patient Monitoring from both In-Network and out-of-Network Physician Offices as well as on demand from Patient/Consumer initiated request for a Remote Consultation. Once any Consultation request has been received or created due to an adverse event associated with a physiological Alert which has triggered, the physician is afforded a complete Medical Encounter Page for use in their response. The system is subscription and cloud-based and includes a native DICOM Viewer for use by provider in connection with patient or referring provider imaging. The system also provides for continuum of care. At the closure of each medical encounter, the system will produce and transmit an Encounter Clinical Summary in C-CDFA format to every member of the patient healthcare team.
- Patient Administration – This sub-system is used to manage a physician’s patient population in regards to the assignment of Medical Devices, and a patient’s usage of said devices to include; Frequency of Use, Low alerts, High Alerts, Notifications of Alerts to what members of the care team and Action Notifications to the patient in response to any abnormal event. Additionally, this is where the physician or care team can assign Disease Management Protocols in the form of Assessments Questionnaires and Patient Education information for transmittal via text and email to the patient. Lastly, from this page view window, the physician can view and graphically trend all of the patient’s physiological data.
- Billing Administration – The ICMyDoctor Encounter Management System provide and embedded Billing Administration program using the medical codes that are automatically generated by the physician during their completion of the Medical Consult Encounter for a given patient. Reports are capable of being generated in either Single or Batch form in both PDF or Excel format suitable for ingestion into the physicians EHR or Accounting Software for final submission for payment.
- Physician’s Profile Management – This section of the navigation pane provides for the ability setup or change; physicians Password, Update Personal Information, Change Notification Methods and Add or Edit Other Care Team Members and Assign Responsibilities.
- DMP Management Resources – This sub-system in the ICMyDoctor is quite unique in that it provides for the ability to Create Custom New Assessment Questionnaires, Clinical Protocols, Patient Education Information Materials specific to a given medical situation. This is accomplished in such a way as to be capable of creating a given DMP in a matter of minutes by way of pre-formatted and automated “clickable” forms design. Once created, they can then be assigned to a particular field of medical and saved for later recall and utilized as explained above. The ICMyDoctor DMP Management comes pre-loaded with a rich set of DMP’s for most every field of medicine. These DMP’s represent the licensed work of some of the most recognized health Institutions in North America.
- My Symptoms Checker – This solution represents a Differential Diagnosis and Care Treatment system which is FDA Approved and certified as 95.1% accurate. When being used in conjunction with a given medical encounter, the patients demographics are preloaded, their symptoms if provided by the patient and with one click will return the top ten diagnosis for that medical situation using AI and other like sophisticated algorithms. The system even has the ability to run causative Drugs Analysis and identity possible Bioterrorist Agents and more. Once a given diagnosis is clicked, the system will navigate to various recognized medical resources which provide recommended care treatment or actions for consideration by the physician.
- ISeeYouNow – This High Definition Video/Audio Conferencing system uses Web RTC technology and is thus P2P based. This system can be used with PC, IOS or Android Mobile devices on demand and includes encrypted protocols for all video and audio from end to end. The solution includes file sharing, text-based chat and the ability to be used with the physicians Scheduler as well as all other commonly used Email Platforms. (Outlook, Google, etc.)
- My Scheduler – This is an all comprehensive and integrated scheduling system calendar for use by the physician and their care team as well as the patient’s portal for use in scheduling a consultation with the physician. A physician can establish their availability both in terms of open time slots for consultation and their general hours of work/day availability.
Comprehensive Virtual Care EMR
This revolutionary and patent pending solution provides total management for an enterprise class deployment involving hundreds
of physicians with tens of thousands of patients simultaneously for eTelehealth Encounters, Chronic Care Management and Remote
Patient Monitoring.
When used for both CCM and RPM, this system has the ability to remotely support many of the labor-intensive delivery of medical
services required in connection with both of these programs automatically and independent of any direct involvement by the
patient’s physician or their local clinical staff. This is accomplished by way GCI providing the physician practice with a Case
Manager and support team who not only monitor RPM results, but assume much of the responsibility of communicating with the
Patient and managing the monthly Care Plan requirements to mention but a few of requirements for reimbursement.
Comprehensive Virtual Care EMR
In support of CCM and RPM, the system has the ability to support and provide third party medical support services for the following major chronic conditions as listed by CMS: (not intended to be all-inclusive)
- Heart Failure: Code 150.9
- Asthma: Codes J45.909
- Hyperlipidemia (High cholesterol): Code E78.5
- Ischemic Heart Disease: Code I.25
- Chronic Obstructive Pulmonary Disease: Code F20.9
- Arthritis (Osteoarthritis and Rheumatoid): Code M13.80
- Atrial Fibrillation: Code I48.91
- Hypertension: Codes I10-I16
- Chronic Kidney Disease: Code N18.9
- Diabetes Codes E10.9, 11.9
Global Care Intl. has partnered with one of our sister companies, CSI Engineering for licensing and distribution rights for a wide variety of FDA Approved Bluetooth Enabled Medical Devices to include:
Note: For more information to include detailed specifications on any of the above, visit: www.myhomeehealth.com
Other Supporting PC-Based and Mobile Solutions (IOS & Android) Integrated into all of above three solutions include:
My Home eHealth Monitor