| |
|
|
|
|
| NOTE: As of 12/31/2021 the Historical Billing Report will be deprecated. | |
|---|---|
| Feature/Functionality | Historical Billing Report |
| Report Filter | Filter by Month, Community, and Product. |
| Add / Remove Report Columns | 15 columns can be enabled/disabled. |
| Display of RPM CPT Code 99453 | CPT code 99453 is automatically added to the Historical Billing Report (one-time) once a patient records their first vitals reading. (This will only appear at the start of the RPM episode and is a one-time code.) |
| Display of RPM CPT Code 99454 | CPT Code 99454 is automatically added every month for all Active RPM patients. (This is independent of Vitals readings. Vitals Readings details are separately available on individual Patient Vitals Reports.) |
| Display of RPM CPT Code 99457 | CPT Code 99457 is added to the Historical Billing Report when the first 20-minute increment of summed time is recorded for the calendar month. |
| Display of RPM CPT Code 99458 | CPT Code 99458 is added to the Historical Billing Report when the first additional 20-minute increment of summed time is recorded. Each additional 20-minute increment reported displays on a new row for the calendar month. |
| Tags | Tags were only available in the CSV download |
| ICD-10 Codes | ICD-10 codes appear comma separated in individual columns. |
UPDATES To the CMS/Payor Billing Report (effective June 4, 2021) – CPT Code 99453 will be automatically added to the billing report only after 16 days of automated readings are reported by the patient. (i.e., 99453 is populated on the report only after 99454 conditions per CMS have been satisfied).
Note: This change is not retroactive and does not affect previous months or the \"Historical Billing Report.\"
Quick Highlights on the Differences between the Historical Billing Report and the 2021 CMS/Payor Billing Report
| Feature/Functionality | Historical Billing Report | CMS/Payor Billing Report | |
| Report Filter | Filter by Month, Community, and Product. | What's New: Revamped the filter and added the ability to Filter by Patient (first name and or last name), Date Range (up to 60 days), RPM CPT Code.
If the Billing Episode Start or End Date of the recorded transaction/s falls within the date range of the filter and all other logic criteria are met for the CPT code, the CPT code will display on the billing report. | |
| Add / Remove Report Columns | 15 columns that can be enabled/disabled. | 20 columns that can be enabled/disabled. | |
| Columns that are different | Columns include admin entered Patient ID, First Vitals Date, Other Time/ RPM Time. Does not include: Billing Episode Start Date, Billing Episode End Date, Current 30-day RPM Billing period, # of days with Readings in 30-day Period. # of RPM Units Recorded, System Tag, and Community Name. | Removed admin entered Patient ID and First Vitals Date. CPT Time Recorded column is a combination of the Other Time Entry and RPM Time Entry fields.
Added: | |
| Display of RPM CPT Code 99453 | CPT code 99453 shows one time once patient records their first vitals reading. (This will only appear at the start of the RPM episode and is a one-time code.) | Before June 3, 2021: CPT code 99453 shows one time once patient records their first automated vitals reading. (This will only appear at the start of the RPM episode and is a one-time code.) | Beginning June 4, 2021: CPT code 99453 shows once the patient records their 16th day of automated vitals readings within 30 days. (This will only appear at the start of the RPM episode and is a one-time code.) |
| Display of RPM CPT Code 99454 | CPT Code 99454 is automatically added every month for all Active RPM patients. (This is independent on Vitals readings. Vitals Readings details are separately available on individual Patient Vitals Reports.) | Before June 3, 2021: CPT code 99454 will display on the new report once at least two (2) days of automated readings within the 30-day billing window (based on the report's date range filter values) have been measured and recorded by the patient. | Beginning June 4, 2021: CPT code 99454 will display on the new report once at least 16 days of automated readings within the 30-day billing window (based on the report's date range filter values) have been measured and recorded by the patient. |
| Display of RPM CPT Code 99457 | CPT Code 99457 is added to the Historical Billing Report when the first 20-minute increment of summed time is recorded for the calendar month. | CPT Code 99457 is added to the CMS/Payor Billing Report when the first 20-minute increment of summed time is recorded for the calendar month. | |
| Display of RPM CPT Code 99458 | RPM CPT Code 99458 only displays when the first additional 20-minute increment is recorded. Each additional 20-minute increment reported displays on a new row for the calendar month. | With RPM CPT Code 99458, if there are multiple instances of complete sets of 20 minutes recorded during the billing period (calendar month), now, one summarized row will display on the report. Still, the units would increment per each set of 20 minutes per the requirement that CPT code 99458 must be 20 minutes of recorded time to qualify for eligibility for the calendar month.
| |
| Tags | Tags were only available in the CSV download. | Tags are available on-screen and in the CSV download. | |
| ICD-10 Codes | ICD-10 codes appear comma separated in individual columns. | Since ICD-10 codes for the RPM episode should relate to the monitored condition/s, the report combines 99457 and 99458 ICD-10 codes recorded into a single comma-separated column. All other instances of CPT code / ICD-10 code combinations are recorded as reported individually. | |
| Billing Episode Start and End Dates | Only available for the CMS/Payor Billing Report. | With the CMS/Payor Billing Report, we added the concept of the billing episode start date and billing episode end date. | |
Before June 3, 2021: – on the CMS/Payor Billing Report: Billing Episode Start Date and Billing Episode End Date for each CPT code
| Beginning June 4, 2021: Billing Episode Start Date and Billing Episode End Date for 99453 has changed:
|
Custom Alerts for Scored Surveys:
A configurable alert that evaluates a survey score based on the configured alert definition. (Ex: An alert is triggered for a survey score above 10). This will only allow a Survey that is created as a “scored” survey to be utilized in the custom alert.
Multivariate threshold alerts for all vitals:
For example: “Custom_Alert_HR and Temperature” alert has both hearth rate and temperature threshold set.
If the heart rate measurement (=50) and is taken 3 days ago AND the temperature (=89) and is taken today. Based on the measurements which are both outside of the threshold ranges. The “Custom_Alert_ HR and Temperature” alert will be triggered.
Note: 5 days rolling average alert for weight & daily average for temperature will consider past values when evaluating whether or not to alert.
===============================================================================================================
Instruction of using multiple alert system with Custom Alert (“X” indicates the alert system has values entered)
| No. | ALERT TYPE | ADMIN THRESHOLD SETTING PAGE | COMMENTS | ||||
| Community Threshold Alert | Individual Threshold Alert | Custom Alert | Active | Inactive | Send Alert | ||
| 1 | X | X | On | On | Trigger \"Community threshold\" & \"Custom alert\" | ||
| 2 | X | X | X | On | On | Trigger \"Individual threshold\" & \"Custom alert\" / Note: Individual Threshold overrides Community Threshold | |
| 3 | X | X | On | Off | ONLY trigger \"Custom alert\" | ||
| 4 | X | X | On | Off | ONLY trigger \"Custom alert\" | ||
| 5 | X | X | On | Off | ONLY trigger \"Custom alert\" |
Impacts of how the graph threshold lines display
How to use:
| |
|
|
|
|