RPM Reimbursement Resources

Stop losing money on telehealth & RPM! Our Expertly Curated Resource center
for reimbursement will help you navigate the CMS Telehealth Guidelines

Spectrum of Reimbursement Models

For healthcare providers to get reimbursed for their telehealth and RPM services, three of the most common reimbursement models that can be used are:

CMS Reimbursement

Commercial Payor Reimbursement

Private Pay Reimbursement

CMS Reimbursement

For healthcare providers, the CMS reimbursement model opens up new revenue streams. The expansion covers a large patient population, ensuring that a significant segment of the community has access to essential telehealth services, including Chronic Care Management (CCM), RPM, and Remote Therapeutic Monitoring (RTM).
This inclusive approach not only benefits patients by providing wider access to care but also supports healthcare providers in extending their reach and enhancing their service offerings.One of the most notable changes by CMS is the broadening of Medicare coverage for RPM, allowing patients to receive telehealth services right from their homes.
This shift eliminates the need for patients to travel to a CMS-qualified telehealth service center, making healthcare more accessible and convenient, especially for those with mobility challenges or residing in remote areas.

We’ve Positively Impacted Thousands Of Patients And Practices.

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Commercial Payor Reimbursement

Healthcare provider’s collaboration with MCOs and ACOs is particularly effective in aligning with the goals of reducing healthcare costs while maintaining or enhancing the quality of care. Engaging with commercial payors through MCOs and ACOs is the potential to access higher reimbursement rates compared to traditional Medicare.
Providers have the opportunity to discuss and agree upon reimbursement rates that are mutually beneficial, taking into account the quality of care and the cost-effectiveness of the services provided. This negotiation process enables a more tailored approach to reimbursement, aligning the interests of both providers and payors.
These collaborations open doors for HHAs to receive reimbursements for a range of services including Chronic Care Management (CCM), RPM, and Remote Therapeutic Monitoring (RTM). Such opportunities are pivotal in enhancing the scope and reach of HHAs in delivering patient-centered care.

Private Pay Reimbursement

The adoption of private pay programs for telehealth services marks a significant shift in healthcare delivery, offering a unique model where patients or their families directly fund the telehealth equipment and services. 

By providing a more flexible and personalized approach to care, patients feel more empowered and involved in their health management. This sense of ownership and control can lead to better health outcomes and a more positive healthcare experience.

The ability to closely monitor health conditions, which helps in early identification of potential health exacerbations. This timely intervention can be instrumental in preventing repeat hospitalizations and emergency department visits, thereby reducing overall healthcare costs and improving patient outcomes.

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Challenges Associated With Reimbursement Models

CMS (Medicare/Medicaid) Reimbursement

Limited to Medicare Part B providers, excluding Part A healthcare providers

Commercial Payor Reimbursement

Necessity of detailed documentation to support necessity

Private Pay Plan Reimbursement

Potential financial burden on patients due to the costs of telehealth services

How Global Touch LLC Helps Providers

Global Touch LLC goes beyond standard reporting. We equip you with a streamlined billing interface and comprehensive reimbursement reports designed to boost your revenue and simplify claim submission.

Effortlessly identify patients eligible for RPM, CCM, or RTM codes

Save valuable time and resources by instantly pinpointing patients who qualify for specific reimbursement opportunities.

Gain granular visibility into your earnings

Dive deep with insightful reports that break down your reimbursement by clinician, condition, subgroup, and more.

Optimize your practice performance

Make data-driven decisions with clear insights into your highest-performing services and areas for improvement.

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