Patients are first onboarded on the TopDocRX RPM program by being provided with FDA approved medical devices that they can use at home to self-measure parameters such as weight, blood pressure, oximetry and blood glucose to name a few. The type of measure and their frequency is prescribed by the clinician through the care plan. A TopDocRX care manager under the general supervision of the physician reviews the patient measurements during the month, exchanging with the patient on their compliance, medication adjustments or other related care topics. Each patient is therefore monitored for chronic or acute conditions outside of the traditional clinical settings.

TopDocRX RPM is a triple win service that rewards all stakeholders: patients, providers and payers.  With RPM, physicians not only keep their patient under control while at home, but also digitize the physician/patient relationship and generate healthy new recurring revenues their practice. According to the AMA, use of RPM in the practice of medicine has nearly doubled in three years, from 13% in 2016 to 22% in 2019. What’s more, 33% of physicians who weren’t using RPM in 2020 are planning to integrate RPM into their practice over the next twelve months.

TopDocRX RPM can help physicians in many ways:

• Provide continuity of care outside the clinical settings
• Engage patients into becoming active participants of their care plan
• Manage population health and embrace value-based care
• While pleasing patients, create entirely new recurring revenue streams
• Service patients where they are keeping safe during the pandemic

Medical providers with a valid NPI (National Provider Identifier) who bill Medicare may participate. Medicare uses the term ‘qualified clinician,’ which can refer to a licensed doctor, nurse, nurse practitioner, and physician’s assistant.

RPM codes are considered Evaluation and Management (E/M) services. CMS stated they can be ordered and billed only by physicians or nonphysician practitioners who are eligible to bill Medicare for E/M services

Centers for Medicare and Medicaid Services (CMS) clarified in the 2021 Proposed Rule that practitioners may furnish RPM services to remotely collect and analyze physiologic data from patients with acute conditions, as well as from patients with chronic conditions,

Eligible patients are those with Medicare or Medicare Advantage plans who have at least one chronic condition and have consented to participate in a remote patient monitoring program.

TopDocRX will send a monthly notification to your biller with detailed instructions on what to bill.  Once the data is reviewed, your biller will be notified prompted to submit a claim for your services to CMS.

RPM devices must be FDA approved medical devices, and the patient measurements must be electronically collected by an RPM system to be monitored by the care manager. This means that the medical device should automatically and digitally upload patient physiologic data. The use of the device must also be reasonable and necessary for either the diagnosis or treatment of the patient’s condition, and the data the device captures must allow for an understanding of the patient’s health with a view to developing and/or managing an established care plan. 

As of October 2020, measurements reported via questionnaires or directly from an App manual input like Pain and Mood, for example, are not recognized as part of the RPM reimbursement.

TopDocRX RPM systems are knowledgeable about billing rules and patient compliance, so they keep track of patients whether they are or aren’t compliant with either their prescribed care plan which is tied to the billing rules. Patient compliance is key to ensure the triple win outcome of an RPM program.