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Glossary

Health Wealth Safe's Glossary


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2

21st Century Cures Act

Federal legislation signed in 2016 designed to streamline the drug and device approval process and promote the development of a more modern and digitized healthcare environment. See also ONC Cures Act Final Rule.


9

98975

a one time billing code for RTM for Initial Setup and patient education on use of equipment


99439

Each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure) (Use 99439 in conjunction with 99490) (Chronic care management services of less than 20 minutes duration in a calendar month are not reported separately)

99453

A one time billed once per patient after getting written consent during an office visit. This code does not apply to verbal consents during a campaign call. It's the initial patient setup/education for RPM services.


99454

A billing code for 16 days of API device data transmission.


99457

Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes (Report 99457 once each 30 days, regardless of the number of parameters monitored) (Do not report 99457 for services of less than 20 minutes)

99458

each additional 20 minutes (List separately in addition to code for primary procedure) (Use 99458 in conjunction with 99457)

99490

Chronic care management services with the following required elements: 
  • Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
  • Chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline
  • Comprehensive care plan established, implemented, revised, or monitored. first 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.

A

Advanced search

Dashboard feature that allows users to narrow down their search in the Population area according to criteria such as first and last name, medical record number, date of birth, etc. This feature is the ideal way to locate specific patients. See also Population.


API device

Any of the devices currently used by HWS that allow patients to participate in and effectively utilize RPM and the HWS app. See also Blood glucose monitor; Blood pressure monitor; Weight scale.


App

For the purposes of this TOC, the HWS smartphone application, available for both iOS and Android phones. This app can be used for all of our services and it an easy way to connect to your physician! 


Application programming interface (API)

A form of software interface that connects computers to other computersor software to other software.


Authorization code

The numeric or alphanumeric code used by care managers to authenticate a completed CCM plan. Care managers have both a personal authorization code and doctor-specific codes used for all clinics for which they complete CCM plans.


B

Blood Glucose

The concentration of glucose (sugar) in the blood. Blood glucose varies over the course of the day depending on when a patient eats, but a level at or exceeding 200 milligrams per deciliter at any time is suggestive of diabetes. See also blood glucose monitor


Blood pressure

The force exerted by blood against the walls of arteries as it circulates through the body.


Body mass index (BMI)

Body mass index. A ratio of height to body weight that can provide indications of an individual’s risk for certain health conditions arising from weighing too much or too little. For adults, a BMI of under 18.5 is underweight, 18.5 to 24.9 is healthy, 25.0 to 29.9 is overweight, and 30.0 and over is obese. In HWS, patients can keep track of their BMI with one of our clinic-assigned weight scales.


BPM

Blood pressure monitor. An API device with which patients can take daily readings of their blood pressure. A blood pressure reading will show two numbers. Systolic pressure (the first number) measures the pressure in the arteries when the heart is actively beating. Diastolic pressure is the pressure in the arteries when the heart rests in between beats. A normal blood pressure level is less than 120/80 mmHg.


C

CAD

Coronary artery disease. Among the most common forms of heart disease afflicting Americans today. CAD is the buildup of plaque in the arteries that supply oxygen-rich blood to your heart, and the resulting narrowing and blocking of arteries can lead to a heart attack. There are three main types of CAD: obstructive, nonobstructive, and microvascular.


Campaign call

The first call made by a care manager to a potential patient to register the patient for RPM/CCM and offer them a device.


capitation

the payment of a fee or grant to a doctor, school, or other person or body providing services to a number of people, such that the amount paid is determined by the number of patients, students, or customers.


Care manager

A HWS employee who registers patients for RPM, CCM, and RTM programs and ensures compliance with these programs through patient engagement. The care manager serves as the face of HWS to patients.


Care plan

A strategy for addressing a patient’s persistent health concerns using the HWS app and devices, created and implemented by care managers.


CCM

Chronic care management. A HWS service for patients with multiple chronic conditions that provides them with a detailed care plan customized to their individual ICD-10 codes. To qualify for CCM, a patient must have at least two eligible chronic conditions and qualifying insurance.


chrome

Google Chrome web browser that offers automatic protection from security issues like phishing and dangerous sites. 


Clinical advice

Any act of persuasion or instruction offered to a patient about their healthcare. This would include advising a patient to go or not to go to the emergency room or urgent care. HWS employees, including care managers, should never offer clinical advice to patients, but rather bring patient issues and concerns to the attention of their physician. It is the responsibility of employees to explain the benefits and functions of the HWS app and its related programs, not act as the proxy of a patient’s physician.


CMS

Centers for Medicare and Medicaid Services. A department of the US Department of Health and Human Services that provides health coverage to over 100 million people through programs such as Medicare, Medicaid, the Health Insurance Marketplace, and the Children’s Healthcare Program. The goal of the CMS is to strengthen the US healthcare system and provide improved care at lower costs.


Coinsurance

Insurance pays certain amount of benefit to the provider on each encounter and assign some % responsibility towards subscriber.

Compliance

A patient’s adherence to the guidelines and protocols of the care plan set forth by their physician. In HWS, patients are in compliance if they use their assigned device a minimum of 16 times a month.


Copayment

A fix amount that need to be paid by the policy holder directly to the provider before each visit/encounter.

D

Dashboard

In general, a dashboard is a type of digital user interface that presents a unified set of data about disparate topics. In HWS, the dashboard for desktop computers and the app is how employees access patient profiles and data and how patients can complete TM calls with their physician. The HWS dashboard is the base of operations for all the services we provide.


Date of service

The monthly billing date for our services. Abbreviation - DOS


Deductible

It is a fix amount that need to be paid by the insured or subscriber to the provider before actual policy benefits starts.

Device ID

The 7-digit code located on the back of Blood glucose monitor devices that must be entered in the IMEI field when registering a BGM device to a patient in Dashboard.


Device inventory

A daily count of HWS devices (BPM, BGM, WS, glucometer testing strips, and lancets) present in the clinic that must be completed by administration assistants and communicated to the devices manager.


Diabetes Management

This is a new management dashboard found on the applications tab or on your HWS Staff App. The dashboard filters a clinics population to only display patients diagnosed with diabetes DX Codes e.g E.08 - E13.9. The custom dashboard displays patients 14 day blood glucose values along side  above and below ranged percentiles. Patients that need attention (have abnormal ranges) are viewed at the top of the list as 'needs' attention. This functions allows providers quick access to patients to make corrective actions. Patients that are on our RPM program with the diagnosis codes will automatically be enrolled into the diabetes management system. 


Diagnosis code (DX Code)

A combination of letters and/or numbers that is assigned to a particular diagnosis, symptom, or procedure. In HWS, diagnostic codes can be found in the dashboard under the patient’s profile and are used to assign the care plan and devices appropriate to the patient’s needs. See also ICD-10 codes.


E

E66

The group of ICD-10 codes referring to obesity.


EMR

Electronic medical record. Each patient in the clinic is assigned an EMR number, which is used by HWS and clinic employees to locate the patient in MCW and the HWS dashboard.


Engaged

A patient’s status when they are in full compliance with their care plan. A patient is considered fully engaged when they are actively participating in their RPM program by completing health surveys, participating in telemedicine, and using their API device at least 16 times a month.


Escalation

The process of using the HWS dashboard to advance a patient’s request for a TM appointment with their physician. Clinics are then responsible for responding to the escalation, and escalations are cleared from the dashboard after 72 hours.


F

First Follow-up

The first follow-up is the first call to the patient after the patient has been registered. The first call is made 7 day after the date of registration. It is during the first follow-up where the care manager goes over the patients care plan if the patient has one.


G

G0506

Comprehensive assessment of and care planning by the physician or other qualified health care practitioner for patients requiring CCM services (billed separately from monthly care management services) (Add-on code, list separately in addition to primary service) (Billing practitioners can bill G0506 only once, as part of initiating visit) (Always need to be billed with an office visit code 99212 with $1.00)

Glucometer

Another term for Blood glucose monitor.


H

Health Insurance Marketplace

Also known as Healthcare.gov. The US government-run health insurance exchange website established as a provision of the Affordable Care Act of 2010.


Health Maintenance Organization

Patients need to choose their PCP which will refer to other specialist if needed. Referral is needed for specialist visits.

Health survey

Questions in the HWS dashboard assigned primarily to assess a patient’s overall daily condition in an RTM program. Questions cover topics such as pain levels, amounts of exercise, personal feelings, etc.


Heart disease

The broad term for a variety of conditions that affect the heart, including blood vessel diseases such as coronary artery disease, congenital defects, infections, and heart rhythm problems. Most forms of heart disease are referred to by the ICD-10 codes I00-I99, which also cover other circulatory system disorders.


HIPAA

The Health Insurance Portability and Accountability Act of 1996. HIPAA ensures that patient records remain confidential and imposes strict financial and even criminal penalties for violations. Remaining in compliance with the stipulations of HIPAA is essential for any medical institution. See the HIPAA training course for more information about this legislation.


Hypertension

The technical term for high blood pressure. This is one of the most common diagnoses you will see among HWS patients. Hypertension is referred to by the ICD-10 code I10. See also Blood pressure; BPM.


I

I00-I99

The ICD-10 codes refer to heart conditions and other diseases of the circulatory system.


I10

The ICD-10 code for essential (primary) hypertension.


ICD-10 codes

A standardized classification system of diagnostic codes used universally in medical claim reporting. Codes represent conditions, diseases, symptoms, abnormal findings, and even social circumstances. Familiarity with ICD-10 codes See also Z-codes.


IMEI number

The unique 15-digit number located on the back of each Blood pressure monitor and Weight scale device that allows ACH and HWS employees to successfully assign devices to individuals and keep track of them through the HWS Dashboard inventory. The IMEI number must be entered in the Dashboard upon registering a device to ensure that the specific device is attached to the individual account. Blood glucose monitors also have an IMEI number located on the back of the device, but this is not the number that is entered when registering a device. Instead, make sure you enter the 7-digit Device ID in the IMEI number field.


In Network Providers

The network of Providers within a geographical area of patients health insurance.

insurance

Insurance is a legal agreement between two parties – the insurer and the insured, also known as

insurance coverage or insurance policy. The insurer provides financial coverage for the losses of the insured

that s/he may bear under certain circumstances.


Insurance Sheet

The Insurance sheet can show you all the current eligible insurances that cover our services. It can be found here.


J

Jira


Jira is a Software designed to help teams manage work efficiently.  Jira was first designed as a bug and issue tracker.  Jira has since evolved into a powerful work management tool for all kinds of use cases, from requirements and test case management to agile software development.


M

Master patient population

The sheet used to track each care manager’s patient population in each of the clinics. This list is updated by the clinic leaders.


MCW

MyChartWriter -The EMR management program used by HWS employees to manage clinic patients. MCW is used to view and update the daily clinic schedule, add notes about patient interactions, upload clinic notes, and to store other relevant patient information and documents. MCW is also used by employees to clock in and out of work and view their timesheets.


Medicaid

The US federal and state program that assists low income individuals and families with their healthcare costs. For the purposes of HWS, patients who have Medicaid as their primary insurance are not eligible for products and services beyond telemedicine.


Medicare

The national health insurance program that provides Americans ages 65 older and those with qualifying disabilities with health insurance. Medicare covers about 60 million Americans. HWS patients who use Medicare as their primary insurance may qualify for programs and services we offer such as RTM and RPM.


MRN

Medical records number. Also known as simply MR. A numeric or alphanumeric code used to locate specific patients in the Dashboard or My Chart Writer. When sending communication about specific patients, refer to them using their MRN rather than their names to remain HIPAA compliant.


Musculoskeletal system disorders

Injuries or diseases that affect the muscles, nerves, tendons, joints, cartilage, and/or spinal discs. Common musculoskeletal disorders include osteoarthritis, autoinflammatory syndromes, and osteoporosis; musculoskeletal system disorders are in general referred to with ICD-10 codes M00-M99, with some exceptions.


N

Needs attention

Section of the dashboard housing all the patients flagged by the system for abnormal or out of range responses to await review by care managers, who will contact the patient if necessary to determine if they need further assistance.


O

Obesity

The condition of having too much body fat, present when an individual’s BMI exceeds 30. The many different forms of obesity are referred to with the ICD-10 code E66.


ONC Cures Act Final Rule

A provision of the 21st Century CURES Act that guarantees patients in the US the right to access their electronic health information free of charge at any time they choose.


OOR

Out of range response. This is an API device reading that differs significantly from those normally received from a given patient, such as an unusually high BS or BP. Such responses are then flagged by the HWS system so the patient can be contacted by a care manager.


Out of Network Providers

Any provider out of patients geographical area or patients insurance network is called out of network providers.


P

Passbolt

HWS utilizes passbolt to manage and secure passwords for our various platform. This is a secure google chrome extension which can be installed on your work computer.


Patient

The person who visits doctor for any kind of counseling, wellness checkup or to get treated for symptom of an illness is called the patient.

Patient Demographic Information

Some specific information that needs to create a patients account in Doctor’s system. Such as name, sex, address, phone numbers, date of birth and insurance information.

Payer

The insurance company who covers patient for any disease or illness and pay to the Doctor when a claim arise.

PICNIC

An acronym care managers use for remembering the structure of a 5 star call for patient engagement voice calls. Preparation, Introduction, Connections, Name use, Information gathering & documenting; Closing the call


Population

In Dashboard, the total number of patients currently listed in the AHC/HWS system. This list can be narrowed according to the criteria available in the Advanced search function.


Practice

A place where the services are performed. Sometimes it is same as the name of the Doctor e.g. Dr Mark Spencer Clinic, Pain Management Center of Georgia etc.

Preferred Provider Organization

Patients have freedom to choose their provider at the cost of higher copays or deductibles.

Provider

Doctor who provides treatment to the patient and charge to their insurance company for payment.

PT

Acronym for patient


Push notification

An automated message sent to the user by an app that the user is not actively using (that is, the app is working in the background). These are messages displayed outside the app that remind (or ‘push’) the user to re-engage with the app.


Q

Quality Check

Quality check is done to prepare for a patient engagement call (RPM, CCM or RTM).
It pertains to gathering information on the patients profile to have a better understanding on who you're talking to and what their past with our service may have been.

  1.  Start by checking the device status to see if they have been using their device (whether or not it's been shipped etc). If there are responses, check how frequent the patient is using their device. 
  2. Check patient's last engagement and the last time the patient was called (this can be found on the notes section). 
  3. Ensure that the diagnosis codes are on the patients profile, if the patient does not have a diagnosis code on their profile forward the patient to your star manager, registration team, or billing team to get missing dx codes.
  4. Check the make sure that the patient has qualifying insurance listed on their profile. Eligible insurance can be found here. If the patient is missing the insurance, send a message to the billing team or your star manager requesting the information to be updated. [Located in Care Managers - RPM - Engagement Calling]


R

Rcopia

 the electronic system that AHCSPC uses to send prescriptions to the pharmacies.


Red Carpet Registration

Red Carpet Registration is a new service offered by Health Wealth Safe. Typically, this involves someone from our registration team to go to the physician’s office to offer in-person training to the staff and physician. Not only that, but they will begin to register patients as they come into the physician practices. Essentially it's the rapid enrollment of a clinic.


Registration

The process of a care manager or other HWS employee calling a patient or approaching them in the clinic to enroll them in the HWS program and set up the delivery of their API device.


Respiratory system diseases

Diseases that affect the lungs and other parts of the respiratory system. These disorders can be caused by infections, smoking tobacco, and other negative environmental exposures. Respiratory system diseases are commonly referred to by the ICD-10 codes J00-J99, except for smoking-related illnesses, which are usually referred to by Z-codes, and certain other conditions.


RPM

Remote patient monitoring. The primary service offered by HWS, RPM uses digital technology to observe and assist patients outside of traditional clinic settings and allows them to take a more active and engaged role in their own healthcare.


RTM

Remote therapeutic monitoring. This is a more recent service offered by HWS aimed at patients with musculoskeletal and respiratory system conditions. It uses diagnosis-specific health surveys that patients can complete via the app. Care managers track patient responses to these surveys so they can quickly address any problems that may arise.


S

sleep apnea

 a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea. The main types of sleep apnea are: Obstructive sleep apnea, the more common form that occurs when throat muscles relax.


SMS notification

A ‘short message system’ message, that is, a text that businesses or governmental agencies send out to large numbers of people to inform them about news, updates, emergencies, and so forth. Examples would include AMBER Alert notifications, order confirmations from an online retailer, or updates on current sales from a business.


Subscriber

The Person who has the insurance policy is subscriber. A patient visiting a Doctor may be covered under someone’s else policy e.g. a child or spouse under husband’s policy.

Super Admin

Is a user who has complete access to the major functions of the health wealth safe's dashboard interface. 


Support manager

 A support team member is a professional who is responsible for handling patient queries, login requests, and complaints regarding HWS or AHCSPC. 


Suppression

Indicates that a care manager was unable to reach a patient and that another attempt must be made to call them 5-7 days later from the initial call attempt.


T

Telemedicine

HWS provides this technology service free of charge for partnered physician use. TM is implemented through the HWS app and allows physicians to conduct virtual clinic visits, streamlining care and fostering more direct and efficient communication between patients and doctors.


V

V3

Our secure platform that allows uniform and easy communication between all parties in HWS across three channels: voice, video, and text messaging. This platform protects patient information and maintains HIPAA compliance while remaining accessible from all around the world.


verbal consent

Consent given over the phone by a patient to a registration care manager. Members of the registration team call partnered clinic patients to invite them to begin services if they are eligible for services.


W

Weight scale

Weight scale. One of the API devices offered to HWS patients. Weight scales are used primarily for patients with diabetes and other weight-related conditions so they can keep track of their progress on a daily basis.


Welcome call

A call care managers make to new patients to introduce them to HWS and explain its many products and services. Better known as first follow-up call.


WIP

Acronym for work in progress, a box on the population dashboard that can be clicked to show that a care manager is currently working on their 'WIP' patient


written consent

A document signed by a patient consenting to digital health services. Written consents are provided to the clinic by HWS. The clinic is responsible for sending in written consents to register patients. 


Z

Z-codes

A type of diagnostic code used in situations in which a patient requires service but does not have a specific condition or injury, or in which a patient needs to address a problem arising from a social determinant of health (such as homelessness or unemployment). For the purposes of HWS, Z-codes cannot be used to determine eligibility for RPM or any of our other offered programs or devices.



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