Remote Patient Monitoring Superbill and Supervising Providers (Released Wednesday, April 7, 2021)

This article describes a feature used with the Remote Patient Monitoring (RPM) feature.  The information and opinions contained herein are for general information purposes only, are not intended to constitute legal or other professional advice and should not be relied upon nor treated as a substitute for specific advice relevant to particular circumstances. We make no warranties, representations or undertakings about any of the content of this guide (including, without limitation, any as to the quality, accuracy, completeness or fitness for any particular purpose of such content), or any content referred to herein. We make no representations, warranties or guarantees, whether express or implied, that the content of this guide is accurate, complete or up-to-date

Beginning Wednesday, April 7, 2021, the Remote Patient Monitoring feature now includes the ability to generate a superbill.  In addition, each RPM episode of care now requires a supervising provider be selected, along with at least a primary diagnosis.

Billable Service Preferences

On the provider dashboard, the Billable Services tab in the clinic settings page now holds settings for both the company's TIN and and Supervising Providers.  To navigate to this page, click Account->Clinics in the left hand menu, select the desired clinic from the listing, and click the Billable Services tab.  These settings may only be edited by coaches with the admin permission for the clinic:

TIN
The Taxpayer Identification Number (TIN) is the IRS tax processing number associated to the clinic that is billing for insurance-based services.  This number will likely be entered once during the initial implementation setup, and is unlikely to be changed again.

Supervising Providers
Each new RPM episode of care created going forward will require the selection of single Supervising Provider.  This provider/coach is the medical professional responsible for overseeing the care of the patient for the selected billable service.  Highlights of the Supervising Providers listing are as follows:

• Adding a supervising provider
  Click the 'Add Coach' button above the Supervising Providers listing.  A modal will be presented, where any existing coach can be searched for (by email or name) and subsequently added to the listing.  Once the coach is added to the listing, they will become immediately available to new RPM episodes of care
• Removing a supervising provider
  In the Supervising Providers listing, click the trash can icon in the Actions column.  You will be prompted to confirm the removal.
• Removing a supervising provider does not impact existing RPM episodes of care
  If a supervising provider was previously available and associated to an RPM episode of care, removing the supervising provider from the clinic listing will not impact that episode of care.  The RPM record will continue to show the supervising provider.
• New coach accounts must be added if needed for supervising provider purposes
  In the scenario that a necessary supervising provider account does not exist in the system, you must create the necessary coach account.  You may add new coach accounts by clicking the Add New Coach button at the top of the coaches listing.

New Requirements When Activating RPM Episode of Care

When activating RPM episodes of care from this point forward, both a supervising provider must be selected and at least a primary diagnosis entered:

Supervising Provider

One supervising provider must be selected.  To clarify, all supervising providers listed in the Billable Services->Supervising Providers table will be available for selection.

• Once the selection is made and the episode of care is started, the supervising provider cannot be changed.
• If only one supervising provider is available, it will be selected by default
• If no supervising providers are available, the RPM episode of care cannot be activated.  A notice will be displayed to the coach, directing them to the Billable Services clinic settings page.

Primary and Secondary Diagnoses

Both a Primary Diagnosis and Secondary Diagnosis fields are presented.  A primary diagnosis is required to be entered for when activating an RPM episode of care.  The secondary diagnosis is optional.

Editing Primary and Secondary Diagnoses

Once an RPM episode of care is started, the diagnoses may be edited but are subject to restrictions:

• Within 24 hours
  Within 24 hours of starting an RPM episode of care, both the primary and secondary diagnoses may be edited an unlimited number of times
• After 24 hours
  After the first 24 hours have elapsed since activating the RPM episode of care, the diagnoses may be modified only one time.  During that process, the coach is required to include an additional note for audit or explanatory purposes. 

RPM Superbill

In addition to the RPM Billing Report, a Superbill is also now available for download.  This report can be downloaded by clicking the Export Superbill button, located on the Reports->RPM link from the left hand menu.  Any currently entered filter by account name will also be applied to this exported report.  Leaving the filter field blank (the default settings) will ensure that all available accounts for the selected clinic are included in the report

The Superbill report will be generated as an Excel spreadsheet.  A separate sheet will be created for each patient, and use the patient name as the sheet title.  An example of a single patient sheet is as follows: