Home Specialities RPM / CCM / Telehealth
RPM · CCM
BHI & PCM covered
Eligibility
automated across all payers
High volume
tens of thousands of claims / mo
Low cost
to collect on low-dollar claims
The denial isn't a coding error — it's a missing time log.
RPM and CCM are recurring, low-dollar, high-volume programs. The revenue doesn't leak where you'd expect: it leaks when a patient is billed who's no longer eligible, when the clinical time or device readings don't meet the requirement, or when overlapping programs are billed against the rules.
And because each claim is small, a high cost-to-collect can erase the margin entirely. Profitability here depends on automating eligibility, enforcing documentation, and collecting cheaply — at scale.
Make the math workWhere recurring-care revenue leaks
The recurring-care revenue cycle, end to end
Built for high-volume RPM, CCM, BHI, PCM, and telehealth — engineered for compliance and a low cost-to-collect.
Eligibility automation
Monthly eligibility verified across commercial and government payers at scale, before a claim is ever submitted — so you never bill a lapsed or ineligible patient.
Enrollment & consent
Program enrollment and documented patient consent tracked for every RPM, CCM, and BHI patient.
Time-log & device compliance
Clinical time and device readings audited against payer requirements — the 16 days of readings and 20 minutes of time — before billing.
RPM / CCM / BHI / PCM coding
Correct codes and units across RPM (99453–99458), CCM (99490–99489), BHI, and PCM, with the right modifiers each cycle.
Telehealth & overlap rules
Telehealth place-of-service and modifier accuracy, plus concurrency rules that prevent overlapping RPM, CCM, and BHI denials.
Denials & recurring-revenue reporting
Proactive denial management and a dashboard showing billable patients, revenue, and denials by practice and service line.
How a national RPM platform scaled to 35,000 claims a month — and cut cost- to-collect to 5.1%.
A Florida-based national remote monitoring and chronic-care platform running across 80+ affiliated practices, with eligibility bottlenecks and documentation denials threatening profitability as it scaled.
The challenge
- High denial volumes from missing clinical time logs and overlapping billing rules.
- Claims submitted for non-covered patients due to eligibility bottlenecks.
- High cost to collect eroding profitability on low-dollar claims.
- Fragmented clinical and billing workflows.
- Poor visibility across practices and a growing eligibility backlog.
What OneMed did
- Deployed a centralized high-volume RCM engine engineered for RPM and chronic care.
- Automated monthly eligibility for 65,000 patients (25K commercial + 40K government).
- Audited clinical time logs and device data for payer compliance.
- Processed 35,000+ RPM, CCM, and BHI claims monthly with zero backlog.
- Proactive denial management and consolidated reporting by practice and service line.
| Revenue Cycle Metric | Before | After | Industry Benchmark |
|---|---|---|---|
| First-pass claim acceptance | 82% | 95% | 90% |
| Average days in A/R | 45 days | 28 days | 30–40 days |
| Overall denial rate | 18.5% | 6.2% | 5–10% |
| Cost to collect | 12.5% | 5.1% | 8–10% |
| Net collection rate | 89.0% | 98.4% | 95–98% |
| Claims accuracy rate | — | 99.7% | 95–98% |
| Monthly claim volume | 28,000 | 35,000+ | — |
~$2.2M
estimated annualized net revenue from improved eligibility capture — no added billing headcount.
Cost to collect cut from 12.5% to 5.1%Denial rate reduced from 18.5% to 6.2%
65,000 eligibility checks per month automated
"Processing over 35,000 chronic care claims and 65,000 eligibilities a month across 80 practices requires absolute precision. OneMed automated our commercial and government eligibility checks while enforcing strict compliance on our time logs. They dropped our cost to collect to a level that actually makes economic sense for remote monitoring, and gave our leadership total visibility into our financial performance."— Vice President of Revenue Cycle, National RPM Platform
Results measured across the engagement; the $2.2M revenue figure is an estimate. Benchmark ranges are industry references. Figures reflect this client's outcomes; results vary by program mix, payer mix, and baseline.
Know exactly who's billable this month
Recurring programs live or die on knowing which patients are eligible, documented, and billable each cycle. Our dashboard shows billable patients, revenue, and denials by practice and service line — so nothing lapses silently and leadership sees the whole book in real time.
- Billable patients this cycle, by program and practice
- Eligibility and consent status at a glance
- Time-log and device-reading compliance flags
- Denials and recovery by service line
- Revenue by practice — one source of truth
From eligibility to paid, every cycle.
A high-volume workflow that keeps recurring claims compliant, clean, and cheap to collect.
Eligibility automation
We verify eligibility across commercial and government payers every month, at scale, so only covered patients are billed.
Enrollment & consent
Program enrollment and documented consent confirmed for every patient before recurring billing begins.
Time & device compliance audit
Clinical time logs and device readings audited against payer requirements before each claim goes out.
High-volume claim processing
Tens of thousands of RPM, CCM, BHI, and PCM claims processed each month — with zero backlog.
Denials & recurring-revenue reporting
Proactive denial management, with a live dashboard of billable patients and revenue by practice and service line.
Who We Serve?
Recurring-care billing for platforms and networks that run at volume.
RPM & CCM platforms
National and multi-practice remote-monitoring and chronic-care platforms billing tens of thousands of recurring claims.
Telehealth & virtual-care groups
Virtual-care providers navigating telehealth place-of-service, modifier, and payer-parity rules.
Multi-practice chronic-care networks
Networks managing RPM, CCM, and PCM across many affiliated practices and payers.
Behavioral health integration (BHI)
Programs billing BHI and collaborative care that require strict time and documentation compliance.
Compliant at every reading and every log
Patient and financial data handled inside a controlled, auditable environment across every practice.
Request a recurring-revenue review.
Tell us about your programs and volume, and we'll show you where eligibility, documentation, and cost-to-collect are costing you margin — and how we'd fix it at scale.
- Eligibility, time-log, and concurrency review of your current setup
- A cost-to-collect assessment for your low-dollar claims
- High-volume processing with no added internal headcount
- HIPAA-compliant, with a BAA executed before any data moves
Request your review
We'll reply within one business day to scope it with your team.
Common questions.
Which programs do you bill — RPM, CCM, BHI, PCM, telehealth?
All of them, including the concurrency rules that govern billing them together for the same patient.
How do you handle eligibility at scale?
We automate monthly eligibility verification across commercial and government payers, so ineligible or lapsed patients are caught before billing.
Do you audit clinical time logs and device data?
Yes. We audit clinical time and device readings against payer requirements before claims go out, so documentation denials drop.
How do you prevent overlapping or concurrent billing denials?
We apply the concurrency rules across RPM, CCM, and BHI so services billed together for a patient don’t conflict.
Can you handle high claim volume without adding our headcount?
Yes. Our engine processes tens of thousands of recurring claims monthly without backlog, and without new internal hires.
Do you bill telehealth visits too?
Yes, with correct place-of-service, modifiers, and payer-specific telehealth rules.
Make your recurring-care programs profitable at scale
Request a recurring-revenue review and see where eligibility, documentation, and cost-to-collect are costing you margin.