Beginning January 1, 2026, UnitedHealthcare (UHC) will dramatically narrow coverage for Remote Physiologic Monitoring (RPM) across its commercial, Medicare Advantage, and exchange plans...
If you are billing RPM for Diabetes, Hypertension, or COPD under UHC, your claims will likely be denied starting January 1st.
If UnitedHealthcare (UHC) is a significant payer for your practice, you need to audit your Remote Patient Monitoring (RPM) panel immediately....
If you run an independent practice, there is a good chance remote patient monitoring is a sore subject.
You might hear the term 'RPM' and immediately think of a 'gold rush' vendor that flooded your staff with devices, made massive revenue promises, and then vanished when the audit letters started showing up. They left you with messy documentation and a billing setup that never felt like it would survive a serious review...
Primary care is carrying more risk, more responsibility, and more expectation than ever. The opportunity is that we finally have a model that pays for the work most teams already do between visits. The risk is jumping into tooling and tactics before we agree on the basics....
Advanced Primary Care Management represents Medicare's most ambitious attempt to transform primary care economics. Unlike previous programs that nibbled at the margins, APCM fundamentally restructures how practices organize, deliver, and bill for comprehensive care...
Advanced Primary Care Management (APCM) is Medicare’s newest program, introduced in 2025 with three billing codes: G0556, G0557, and G0558. This represents a pivotal shift toward value-based primary care by offering monthly reimbursements for delivering continuous, patient-focused services. You're already providing these services—why not get paid for it?
If you've spent any time managing a remote patient monitoring (RPM) program, you already know the drill: juggling the 16-day rule, keeping track of clinical minutes, chasing compliance, and often wondering if this is really what patient-centered care was meant to feel like...
It starts with a data spike… a sudden drop in movement, a rise in reported pain. The alert pings the provider dashboard, hinting at deterioration. But what if that signal isn’t telling the whole truth
Chronic pain isn’t just a condition, it’s a thief. It steals time, joy, and freedom from over 51 million Americans, according to the CDC, costing the economy $560 billion a year. As someone passionate about healthcare innovation, I’ve seen how this silent struggle affects patients, families, and providers...
Picture Mary, 62, balancing a job and early diabetes. Her doctor, Dr. Patel, is her anchor—reviewing labs, coordinating with a nutritionist, tweaking her care plan. But until 2025, Dr. Patel wasn’t paid for this invisible work...
In healthcare, most of the time, trouble doesn't announce itself with sirens and red flags. It starts quietly. A free dinner here. A paid talk there. An event that feels more like networking than education...
The Office of Inspector General’s (OIG) 2024 report, Additional Oversight of Remote Patient Monitoring in Medicare Is Needed (OEI-02-23-00260), isn't just an alert—it's a detailed playbook exposing critical vulnerabilities in Medicare’s Remote Patient Monitoring (RPM) system...
Feeling like you’re drowning in regulations designed by giants, for giants? If you're running a small practice in today's healthcare hellscape, it damn sure feels that way...
When people ask me what Intelligence Factory does, they often expect to hear about AI, automation, or billing systems. And while we do all those things...
“They’re going to put me out of business. They want over a million dollars. I don’t have a million dollars”, his voice cracked over the phone...