Specialized RCM Partnerships for Forward-Thinking Healthcare Providers

Physician practices running CCM programs face a unique billing challenge: every patient requires monthly time documentation, care plan documentation, and payer-specific code selection. Add RPM device monitoring and you have one of the most documentation-intensive billing workflows in medicine.

• Daily eligibility checks prevent surprise denials at billing cycle end
• RPM device-day thresholds tracked automatically for every patien
• CCM time logs validated against documentation before claim submission
• Percentage-based pricing aligns our incentives with your revenue

When CMS proposed the CY 2027 direct employment requirement, many turnkey vendors stepped back from clinical and billing support. This leaves practices stranded with devices but no compliant way to bill. We specialize in seamless transitions: auditing your current setup, aligning workflows with CMS requirements, and taking over billing without missing a cycle.

• Compliance gap analysis of your current vendor setup
• Workflow alignment with CY 2027 direct employment/MSO rules
• Seamless billing transition with zero revenue interruption
• Staff training on initiating visit documentation requirements

ACOs and health systems face a different billing challenge: scale, complexity, and the need to maximize performance-based revenue across multiple programs simultaneously. CCM enrollment rates, RPM adherence, and telehealth utilization all directly affect quality scores and shared savings.

• Consolidated reporting across multiple payers and program types
• APCM and PCM code optimization for complex patient populations
• Credentialing management for large provider networks
• Denial pattern analysis to identify systemic payer issues early

Specialty practices run the highest-complexity RPM and RTM programs. A cardiologist managing remote cardiac monitoring, an endocrinologist tracking CGM data, a pulmonologist using spirometry RTM. Each has specific device types, specific documentation requirements, and specific payer rules for reimbursement.

• Specialty-specific CPT code selection for each device type and program
• RTM respiratory and musculoskeletal coding expertise
• Prior authorization management for specialty RPM devices
• Telehealth consult codes for inpatient specialist billing

Telehealth billing changed significantly in 2025 with new dedicated telehealth CPT codes. Telehealth companies need a billing partner who stays current with these changes, understands modifier requirements, and knows how different payers interpret audio-only versus audio-video service requirements.

• New 2025 telehealth CPT code series applied correctly from day one
• Modifier 95 and 93 applied correctly for audio-video versus audio-only
• Place-of-service 02 and 10 used correctly per payer requirements
• Multi-state credentialing for telehealth providers practicing across state lines

Home health agencies increasingly operate CCM, RPM, and TCM programs alongside traditional home health services. Each program has different billing requirements, different payer rules, and different documentation standards. Managing all of them simultaneously requires specialized expertise.

• TCM post-discharge billing managed within required contact timelines
• Eligibility verified before every care episode to prevent denials
• Short-term RPM billing for transitional monitoring patients
• Secondary payer management for dual-eligible patients