Gestion des soins prolongés à distance
Our clinical team of more than 130 RNs, LPNs, NPs, and MAs are specifically trained in Remote Patient Care Management, and becomes an extension of your practice, part of your team, with no additional cost.
The team will follow your protocols, while improving patient outcomes, fostering greater engagement, and facilitating better communication and coordination of care. And before they start with your patients, you will be able interview and approve each one assigned to your practice.
Once onboard, they will closely monitor patient health data in real-time, enabling prompt intervention and treatment. This approach enhances the efficiency and effectiveness of care, leading to improved patient health outcomes and minimizing the likelihood of complications.
SERVICES DE SOINS VIRTUELS
Pratiques médicales
Organisation de soins responsable
Pratiques médicales
CHRONIC CARE MANAGEMENT (CCM) is the care coordination that is outside of the regular office visit for patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation or decompensation, or functional decline. It can be delivered to people with many different types of health conditions. CPT: 99490, 99439
REMOTE PHYSIOLOGICAL (or Patient) MONITORING involves the use of non-face-to-face technology to monitor and analyze physiological metrics of patients’ health such as blood pressure, oxygen saturation, blood oxygen levels, weight gain/loss, etc. CPT: 99454, 99457, 99458
REMOTE THERAPEUTIC MONITORING (RTM) Tracks a patient’s adherence to a therapeutic plan of care. According to the 2023 CMS Final Rule, RTM technology can be used to measure respiratory system status, musculoskeletal system status, therapy adherence, and therapy response. CPT: 98976, 98980, 98981
BEHAVIORAL HEALTH INTEGRATIONS (BHI) CMS supports behavioral health practices to provide integrated care and help meet people's behavioral needs, such as social isolation, depressions and cognition housing, all of which can negatively impact a person's ability to manage their care. CPT: 99484
ANNUAL WELLNESS VISIT (AWV) allows a practice to gain information about the patient, including medical and family history, health risks, and specific vitals. Not to be confused with a complete physical examination, the purpose of the AWV is to review the patient's wellness and develop a personalized prevention plan. For AWV, we do work before or during visit to support doctor such as cognitive screening, depression screening etc. It is exactly what an MA or nurse does in a clinic. The doctor interprets and sets the plan. We support the doctor for the health risk assessment (HRA). CPT: G0439
TRANSITIONAL CARE MANAGEMENT (TCM): Medicare may cover transitional care services during the 30-day period that begins when a physician discharges a Medicare patient from an inpatient stay and continues for the next 29 days. These services help eligible patients transition back to a community setting after a stay at certain facility types. CPT: 99495, 99496
SOCIAL DETERMINANTS OF HEALTH (SDoH): CMS strives to improve the collection and use of comprehensive, interoperable, standardized individual-level demographic and social determinants of health (SDoH) data, health literacy, including race, ethnicity, language, gender identity, sex, sexual orientation, disability status, and SDOH. CPT: G0136
CAREGIVER TRAINING SERVICES (CTS) covers caregiver training services for caregivers involved in the treatment of Medicare patients if both conditions apply:
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The training focuses on helping the patient meet the health and treatment goals they set with their doctor or other health care provider.
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The patient needs a caregiver’s help for their treatment to succeed.
If the patient’s healthcare provider determines that caregiver training is appropriate for the patient’s treatment plan, the caregiver can get individual or group training sessions from the provider without the patient present. CPT: 99550
Les services d'INTÉGRATION DE LA SANTÉ COMMUNAUTAIRE (CHI) et DE NAVIGATION POUR LES PRINCIPALES MALADIES (PIN) impliquent une évaluation centrée sur la personne pour mieux comprendre l'histoire de vie du patient, la coordination des soins, la contextualisation de l'éducation sanitaire, le développement des compétences d'auto-représentation du patient, la navigation dans le système de santé, la facilitation du changement de comportement, fournir un soutien social et émotionnel et faciliter l’accès aux services sociaux communautaires pour répondre aux besoins non satisfaits en matière de détermination sociale de la santé (SDoH). CPT : G0019, G0023
Ronald Banther
423-284-7095
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