Program design
Eligibility criteria, target panel, clinical protocols, escalation thresholds and a staffing and economics model.
10 · Telehealth & RPM
Telehealth, RPM & Chronic Care Programs
Recurring revenue and better outcomes come from the same place: patients who are actually managed between visits. We build the program, not just the billing code.
Engagement at a glance
- Engagement modelProgram build fee plus monthly per-enrolled-patient management fee
- LaunchFirst cohort enrolled within 3–6 weeks of kickoff
- DevicesVendor-neutral selection; no commission arrangements
- StaffingWe can supply the care-management staff or train yours
- BillingCodes billed under your tax ID, with documentation you can defend
- ReportingEnrollment, engagement, clinical and revenue reporting monthly
$60–$120
Monthly revenue per enrolled patient
Combined CCM and RPM codes for eligible patients, before care delivery costs.
3–6 wks
Program launch
From design to first enrolled and billed patient.
< 20%
Typical first-year attrition
Well-run programs retain far better than the 50%+ seen in poorly staffed ones.
The problem
Between-visit care that pays for itself.
Chronic care management, remote patient monitoring and principal care management are the rare case where the clinical argument and the financial argument point the same way — if the program is designed to deliver real care rather than to bill a code.
We design the program around your patient population: eligibility rules, enrollment and consent workflow, care-plan templates, device selection and logistics, monitoring thresholds and escalation protocols, documentation standards, and the staffing model that keeps it running at scale.
Then we make sure it is billed correctly and defensibly — the right codes in the right sequence, the required time thresholds documented, and the audit trail that shows the care was actually delivered.
What's included
Everything in this service, in writing.
Enrollment & consent
Patient identification, consent capture, benefit verification, and enrollment paperwork with required documentation.
Device logistics
Cellular-enabled device selection, kit assembly, shipping, patient training, returns and replacement management.
Care plans & documentation
Person-centred care plan templates, monthly comprehensive care plan review, and documentation standards that satisfy audit requirements.
Monitoring workflows
Alert thresholds, triage protocols, nurse and MA workflows, escalation paths and after-hours coverage rules.
Compliance & billing
CCM, PCM, RPM and remote therapeutic monitoring code selection, time tracking, supervision requirements and audit-ready records.
How it runs
The engagement, step by step.
01
Population & economics
We size the eligible panel from your data, model the revenue and staffing cost, and confirm the program clears its own hurdle.
02
Design & build
Protocols, care plans, consent and documentation templates, device selection, and the workflow that ties them together.
03
Enroll & train
Staff training, patient outreach, first cohort enrolled and devices in patients' homes.
04
Operate & scale
Monitoring, monthly reviews, billing, and a monthly operating review that decides whether to expand the panel.
What we hold ourselves to
These are the operational targets we report against for this service. They are industry benchmarks and internal commitments — your results depend on your volume, payer mix and specialty, and we will tell you honestly where you should expect to land.
$60–$120
Revenue per patient/month
3–6 wks
Launch
20 min
Typical CCM time per patient/month
< 20%
First-year attrition
FAQ
Common questions.
Is CCM billing still viable?
Yes, for eligible patients with two or more chronic conditions expected to last at least 12 months. The codes require documented time, a comprehensive care plan and meaningful coordination. Programs that treat it as a paperwork exercise get audited; programs that actually manage patients do well.
Who can deliver the care management?
Clinical staff under the general supervision of a physician, plus clinical staff for RPM depending on the code and payer. We design the staffing model around your licensure, state scope-of-practice rules and payer requirements.
Do we have to buy devices from you?
No. We are vendor-neutral and take no device commissions. We will recommend two or three options with real pricing, cellular versus Bluetooth trade-offs, and patient-support quality.
What about patients who do not engage?
They get disenrolled, and we tell you why. Programs fail when they keep billing for patients who are not participating. We report engagement monthly and manage attrition actively.
Can you run telehealth visits as well?
Yes — platform selection, scheduling templates, consent and documentation standards, and the billing rules for modality and place of service, including audio-video requirements by payer.
Related services
Often bought together.
Medical Billing & Revenue Cycle Management
Charge capture, clean-claim submission, denial work-down, payment posting and A/R follow-up — run by a dedicated team on your existing practice management system.
- Clean-claim rate and first-pass acceptance reporting
- Denial prevention, appeals and underpayment recovery
- Aged A/R worked to a written escalation ladder
Medical Coding & Documentation Integrity
Certified specialty coders, E/M level review, surgical and procedural coding, CDI queries and coding education that sticks.
- Specialty-matched AAPC and AHIMA certified coders
- E/M level distribution and modifier review
- Documentation improvement, not just code correction
Credentialing & Payer Enrollment
Payer enrollment, CAQH maintenance, Medicare and Medicaid, hospital privileging, revalidations and expirables — tracked to the day.
- New-provider enrollment in 60–90 days, tracked daily
- CAQH, PECOS, NPPES and roster maintenance
- Expirables calendar so nothing lapses unannounced
Talk to someone who has run this before.
Thirty minutes with an operations lead who works this service every day. Bring your numbers if you have them; we will tell you what we see either way.
A 30-minute call with an operations lead. No obligation, no sales sequence, and we will say so if you do not need us.