Frequently Asked Questions
Covers every question the audit specifically flagged, plus the standard CCM/RPM questions already answered on the program pages.
What is the actual timeline from signing to the first enrolled patients?
Days rather than months, and the limiting factor is usually not the technology. Records access and eligibility screening move quickly once the agreement is signed. What sets the date is agreeing your escalation thresholds, signing off the care plan templates and briefing your front desk on the enrollment conversation. Practices that arrive at the first call with their clinical parameters settled are typically enrolling inside the first two weeks.
Which EHRs do you integrate with?
The major ambulatory systems, and where a direct integration is not available we work from scheduled data exports and a secure shared workflow instead. Integration is not a prerequisite for launching. It changes how eligibility screening and documentation move between us, not whether the program can run.
What do you need from our practice to get started?
A patient list or records access for eligibility screening, the clinical thresholds and escalation rules you want us to work to, sign off on the care plan templates, and one named clinical contact for anything that needs a decision. That is the whole list. We do not ask for staff, floor space or a device budget.
Who actually calls our patients?
Trained care coordinators working to your protocol, who identify themselves as calling on behalf of your practice, because that is what they are doing. They work from the care plan you approved and the escalation rules you set. Patients experience it as your practice staying in touch between visits, which is the only framing that gets acceptance.
What happens on the monthly call?
It follows the protocol for the patient’s specialty rather than a generic script. Medication reconciliation against what the patient is actually taking, adherence and refill checks, symptom and control review against the markers in the care plan, loop closure on referrals and labs, and the practical barriers that decide adherence more reliably than clinical factors do. Each specialty page sets out what its version covers.
Who responds when a reading crosses a threshold?
Our clinical staff review readings against the thresholds you set during onboarding and follow the escalation protocol you approved. Anything crossing a threshold raises an alert, and anything requiring a clinical decision reaches your on-call clinician with the trend, the symptom check and the medication list already assembled.
Do coordinators make clinical decisions?
No. They collect, they screen against your criteria, they escalate and they document. Interpretation and every treatment decision stay with your clinicians. This is the boundary we are strictest about, because a program that blurs it becomes a liability rather than an asset.
What if patients do not like being contacted by a third party?
Then the program was introduced the wrong way. Coordinators call on behalf of your practice, under your name, working from your care plan, and patients are told that at enrollment and on every call afterwards. Acceptance is high when it is presented as your practice extending its reach and low when it is presented as an outside service. We provide the enrollment script your staff use for exactly this reason.
How does consent work?
Consent is obtained before any billable time is logged and it is documented. The patient is told what the program involves, that participation is voluntary, that they can leave at any time, and, where cost sharing applies to them, that it does. They hear all of that before they agree rather than after.
Does this create a CMS audit risk for our practice?
The exposure in these programs comes from thin documentation and time that was billed but not evidenced, which is exactly what the model is built to prevent. Time is logged against a care plan as the work happens, consent is documented before billing begins, and the record exports in a form that stands on its own. We would rather bill less than bill something we cannot evidence, and we will tell you when a patient should come off the list.
Who submits the claim, us or you?
You do. We prepare and document the encounter, log the time as it happens and export it to your billing system in a CMS compliant form. The claim goes out under your practice, which is why the documentation standard matters as much to us as it does to you.
Who pays for the devices?
We do. There is no device cost to the practice and no equipment for you to buy, store, configure or replace.
Which measurements do you monitor?
Blood pressure, weight, blood glucose and pulse oximetry, matched to the condition rather than issued as a bundle. A measurement has to change a decision to be worth taking, which is why we recommend fewer devices than most vendors and say plainly where the case for one is weak. Each specialty page sets out where the device earns its place and where it does not.
What are the contract terms?
Written to be exited. The agreement runs on a rolling basis with a short notice period rather than a multi year commitment, because a program that has to be contractually trapped is not working.