MDM
Nov 2026
?
36+ claims pending action: OA-109 wrong payer (MA patients), 8 malformed claims, 2 missing taxonomy. View denial analysis →
Total Enrolled
187
across all programs
Bill-Ready Nov
141
≥20 min documented
Action Needed
46
denied or incomplete
Nov Projected
$42.8k
Traditional Medicare
OA-109 Queue
36
eligibility check needed
CCM Minutes Avg
22
min/patient this month
Program Enrollment
Remote Patient Monitoring
CPT 99457 · 99458 · 99453 · 99454
94
Enrolled
71
Bill-Ready
$167
Per patient
$11.9k
Nov proj.
Chronic Care Management
CPT 99490 · 99491 · 99439
162
Enrolled
128
Bill-Ready
$62
Per patient
$8.0k
Nov proj.
Behavioral Health Integration
CPT 99484 · 99492 · 99493
87
Enrolled
63
Bill-Ready
$58
Per patient
$5.1k
Nov proj.
Continuous Glucose Monitoring
CPT 95249 · 95250 · 95251 · A9276
23
Enrolled
18
Active sensors
$145
Per patient
$2.6k
Nov proj.
Recent ERA Payments
Electronic Remittance — Oct 2026
EFT #DateDOS MonthClaimsBilledPaidPrimary CPT
8019362802026-10-19Sep 2026~50~$12,500~$6,00099490 99484
8019115902026-10-09Sep 202640$9,604$5,18899350 POS-12
8018531572026-09-22Aug 2026133$7,400$5,27799457 99484
8017701602026-08-24Jul 202655$3,415$2,29999457 99484
Enrolled
94
active patients
Bill-Ready
71
≥16 days readings
Setup Pending
12
device not activated
OA-109 Denied
11
MA payer mismatch
Nov Projected
$11.9k
99457+99458
RPM Roster
PatientPCNFacilityPayerDeviceReadings/MoStatusNov Billing
OA-109 — Action Required
Tubbs (BD0015)MA?
Webb (C000023)MA?
Zhao (DB0020)MA?
Williams, E (DB0035)MA?
Wu, Pei (DB0040)MA?
Wu, Yuexian (DB0070)MA?
Zhong, Li (DB0075)MA?
Yu, Shukkan (DB0088)MA?
Tseung (DB0092)MA?
Turner (HHS0005)MA?
Washington (MIS0095)MA?
CPT Reference
99453 — Device setup$19
99454 — Supply/month$64
99457 — RPM 20+ min$52
99458 — Add-on$42
Enrolled
162
chronic condition patients
Bill-Ready
128
≥20 min documented
Minutes Short
22
<20 min this month
Missing Taxonomy
2
fix before submit
Nov Projected
$8.0k
CCM Roster
PatientPCNFacilityConditionsMin This MoStatusNov Billing
Fix Before Submitting
Janice (MIS0108)Missing taxonomy 193200000X — claims 880384324–26CO-16/N382/MA130
Gochi-Garcia (HHS0027)Missing taxonomy 193200000X — claims 880384236–38CO-16/N382/MA130
Add 193200000X (NP Family) in Claim.MD before resubmitting.
CPT Reference
99490 — CCM 20+ min$62
99491 — Complex 30+ min$87
99439 — Add-on 20 min$47
Taxonomy required: 193200000X
Enrolled
87
BHI-eligible patients
Bill-Ready
63
Hospice Block
1
Welz SAL005
Nov Projected
$5.1k
Avg PHQ-9
9.4
BHI Roster
PatientPCNFacilityPHQ-9PCP MinStatusNov Billing
Hospice Block
Welz, SAL005CO-B9/N90 — Patient on hospice; CCM/BHI/RPM bundled into hospice per diem. Unenroll immediately.Unenroll from programs
CPT Reference
99484 — BHI mgmt/month$58
99492 — Initial psych collab$224
99493 — Subsequent collab$157
Enrolled
23
diabetic patients
Active Sensors
18
Setup Pending
5
Nov Projected
$2.6k
Avg TIR
62%
target ≥70%
CGM Roster
PatientPCNSensorTIR %Avg GlucoseLast UploadStatusNov Billing
Coverage Note

Medicare Part B covers CGM for insulin-requiring diabetes. MA plans (Humana, Molina, Welcare) often require separate PA before ordering.

CPT / HCPCS
95249 — Training$57
95250 — 72-hr placement$149
95251 — Interpretation$65
A9276 — Supply/day$10–14