As digital tools like Bluetooth-enabled glucometers and Continuous Glucose Monitors (CGMs) become increasingly popular for managing Gestational Diabetes (GDM), many providers are realizing the potential of RPM to enhance care. But while the clinical and financial benefits are clear, questions often arise about how to navigate the complexities of implementation and billing.
This article outlines why RPM is worth considering for your GDM patients, the challenges you may face, and how to overcome them to create a seamless program that supports your practice’s growth.
Clinical and Financial Benefits of RPM
Implementing an RPM program for GDM patients offers significant advantages, both in terms of improving care and increasing practice revenue. We’ve outlined 3 below.
Better Patient Experience and Care
Most patients prefer to capture and share glucose data digitally vs. using paper logs and emailing or faxing these to provider offices. RPM formalizes the process of real-time monitoring of glucose data, giving providers the ability to evaluate trends like fasting and postprandial glucose levels or more granular glucose patterns. This level of detail enables proactive adjustments to treatment plans, resulting in better glucose control and improved outcomes for GDM patients and their babies.
By providing this level of detailed information, patients are empowered to take a more active role in their own care. They gain a deeper understanding of how their daily activities and dietary choices directly impact their glucose levels, leading to more informed decisions and better self-management.
Patients also benefit from the convenience of automated data sharing, eliminating the need for manual glucose logs and ensuring more accurate, timely information for their care team.
Streamlined Workflows
With RPM, manual processes like transcribing glucose logs and paper management become a thing of the past. Digital platforms automate data collection and organization, freeing up time for both providers and staff. Routine tasks, such as device setup and patient education, can be delegated to non-clinical staff, allowing providers to focus on high-value clinical activities.
Furthermore, RPM addresses a common challenge for GDM patients: navigating a fragmented healthcare system. Often, these patients interact with multiple providers, including OBGYNs, endocrinologists, and diabetes educators. RPM creates a centralized platform for data sharing, ensuring that all members of the care team have access to the same real-time information. This seamless flow of data fosters better communication and collaboration among providers, leading to more coordinated, personalized care for the patient.
Increased Revenue Potential Outside the Global Package
RPM programs allow providers to bill for essential activities such as device setup and training, reviewing glucose data, planning treatment, and patient interactions.
Reimbursement rates range from $150 to $300 per month, depending on time spent and carrier policies. For obstetric practices, this is particularly valuable as it provides an opportunity to bill outside the global package. While routine obstetric care is included in the global package, managing high-risk conditions like GDM qualifies for additional reimbursement. This means you can capture the time and effort spent providing specialized care, turning it into a sustainable revenue stream.
Challenges with RPM Implementation and Billing
While the benefits of RPM are clear, there are challenges to consider:
- Complex Billing Requirements: Successfully billing for RPM requires careful attention to nuanced rules, such as tracking time spent on RPM activities, ensuring devices meet eligibility criteria, and
- Initial Setup Effort: Building an RPM program involves creating workflows, training staff, and integrating new tools into your existing processes.
- Maintaining Documentation: It’s important to store the right records and documentation to support claims.
According to the American Medical Association, unfamiliarity with billing codes or concerns about the setup process are major barriers that prevent most practices from taking advantage of RPM.
How to Overcome RPM Challenges
Fortunately, solutions are available to help practices overcome these hurdles and implement RPM successfully:
- Leverage RPM Platforms: Specialized software tools can simplify the process of implementing RPM. These platforms ensure compliance with billing requirements, automate data collection and reporting, and integrate easily into your practice’s existing workflows. LilyLink is a plug and play RPM platform made specifically for maternity care providers managing gestational diabetes (see more information below).
- Automate Documentation and Reporting
Digital platforms track time spent on RPM activities and generate the necessary reports for billing, reducing administrative burdens and ensuring you meet payer requirements. - Access Training and Resources
Educational materials and guides can help your team navigate RPM billing, from understanding coding requirements to establishing workflows.
Why RPM Is Worth the Effort
Setting up an RPM program for gestational diabetes may require an initial investment, but the rewards are undeniable. RPM enables better glucose control for patients, a more seamless care experience, and improved data quality for precise treatment decisions.
Financially, it allows you to bill for high-value activities like device setup and data review, generating revenue outside the global obstetric package. RPM also saves time by automating workflows and delegating routine tasks to staff.
With tools like LilyLink to simplify implementation and billing, RPM is a practical, efficient, and profitable way to enhance care for GDM patients while supporting your practice’s growth.
Access Your Simplified Guide to RPM Billing
Check out our RPM Billing Guide for step-by-step instructions that will help you fully understand the process. You can also schedule a demo with us to start upgrading your GDM care today!