RPM Compliance Under the Microscope:
Expert Guide To Passing an Audit
Expert guidance on avoiding RPM compliance pitfalls.
As remote patient monitoring (RPM) cements its place in modern healthcare, it's drawing increased scrutiny from federal regulators. Most organizations aren’t intentionally committing fraud, but misunderstanding CMS requirements or partnering with noncompliant vendors can be just as risky.
This expert guide, developed by the RPM compliance experts at Prevounce, outlines the most common compliance pitfalls that can lead to failed audits, penalties, and lost revenue. Whether you're launching your first RPM program or fine-tuning an existing program, our guide delivers the proactive advice you need to stay ahead of an RPM audit.
Learn the nine RPM compliance pitfalls that can lead to a failed audit in this expert guide, including:
- Misinterpretation of programmed alerts
- Texting as interactive communication
- Established patient requirement
- Lack of properly documented consent
- General supervision requirements
Disclaimer: Health, economic, and reimbursement information provided by Prevounce is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules, and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.
Prevounce encourages providers to submit accurate and appropriate claims for services. It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services, and to submit appropriate codes, charges, and modifiers for services rendered. It is also always the provider’s responsibility to understand and comply with Medicare national coverage determinations (NCD), Medicare local coverage determinations (LCD), and any other coverage requirements established by relevant payers which can be updated frequently.
Prevounce recommends that you consult with your payers, reimbursement specialists, and/or legal counsel regarding coding, coverage, and reimbursement matters.
Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding, or site of service requirements.
The coding options listed here are commonly used codes and are not intended to be an all-inclusive list. We recommend consulting your relevant manuals for appropriate coding options.
The Health Care Provider (HCP) is solely responsible for selecting the site of service and treatment modalities appropriate for the patient based on medically appropriate needs of that patient and the independent medical judgement of the HCP.
