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LOGIC Health Management

Checklist

Care Management Readiness Checklist

Efficient, compliant Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) programs unlock new reimbursement, improve outcomes, and strengthen patient loyalty. This quick-scan checklist helps physician practices, small hospitals, and RHCs/FQHCs confirm they have the right foundations in place before launching or outsourcing CCM/RPM services.

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Clinical Workflow

  • [ ] Documented Care Plans – Licensed clinicians (RN, NP, PA, or PCP) create and update comprehensive care plans stored in the EMR and made available to patients.
  • [ ] Defined Staff Roles & Licensure – Clinical staff (e.g., MAs, nurses) who perform monitoring operate under CMS general supervision rules, with schedules that support required time thresholds.
  • [ ] Single-Provider Billing Safeguards – Process to confirm no other provider is billing CCM for the same patient in the same month (critical for specialty groups and small hospitals with provider-based clinics).

Technology & Integration

  • [ ] Bi-Directional EMR Integration – Platform can push and pull problem lists, vitals, medications, and encounter notes directly into your EMR to avoid double documentation.
  • [ ] Minimal-Click Workflow – Interfaces require only a few steps for physicians; role-based review queues for nurses reduce friction and training time.
  • [ ] Device & App Reliability – Cellular or well-tested Bluetooth devices minimize "dark devices" and OS update failures; vendor provides patient-facing tech support instead of routing every issue to your front desk.

Billing & Compliance

  • [ ] Current CPT/HCPCS Mapping – Team understands CCM (99490, 99491, 99437, 99439), RPM (99453, 99454, 99457, 99458), and RHC/FQHC composite options such as G0511; stays current on proposed RPM/RTM 2–15-day device-supply codes expected in 2026.
  • [ ] Time & Data Capture Automation – Platform auto-logs staff minutes and validates device-day counts to support audit-ready documentation for CCM and RPM.
  • [ ] Audit Trail & HIPAA Controls – Communications and device data are stored in HITRUST-certified, HIPAA-compliant systems with BAAs in place; the Security Risk Analysis explicitly includes RPM data flows (applies to small hospitals as well).

Patient Engagement

  • [ ] Onboarding & Education Plan – Plain-language instructions, teach-back, and retraining are used to improve adherence beyond simple device distribution.
  • [ ] Multichannel Communication – Care teams can use phone, SMS, and portal messaging to sustain enrollment, support patient-reported outcomes, and reduce no-shows and drop-offs.

Helpful Resources

  • CMS MLN Connects: Chronic Care & Remote Therapeutic Monitoring Code List (Aug 28, 2025).
  • LOGIC Integration Guide: EMR connectivity checklist (internal).
  • Addison Care "Higher Standard" RPM/CCM case study.

What to Do Next

  1. Share this checklist with your care team and mark any gaps in workflow, integration, billing, or engagement.
  2. Prioritize remediation efforts across processes, technology, and staffing before expanding enrollment.
  3. Schedule a readiness consultation with Logic Health Management to quantify revenue potential and map a go-live plan for practices, small hospitals, or RHCs/FQHCs.

Notes & Citations

Bracketed numbers in earlier versions of this checklist (e.g., [7]) map to a full source list published on LOGIC's companion blog/resource page. For detailed citations, refer to “Care Management Readiness Checklist” in the LOGIC blog or resources library.