Medical & Care Management
Care management and reimbursement for practices running CCM, RPM, PCM, BHI and TCM programs. One record carries each patient from the first outreach call through the care plan, the daily care loop and the RPM readings, to the CPT line, the payer's payment and the group P&L. QaiS drafts the encounter note and the patient handouts, and a clinician approves every one.
- Practices and providers: practice setup with Medicare MAC and locality, enabled programs, revenue share, the provider roster and a practice switcher that scopes every screen.
- Patient activation and enrollment: call lists imported in any format, follow-ups, a derived pipeline stage, and opt-out tracking with device returns.
- Care plans built from the Conditions Library, submitted by the care manager and approved or returned by the provider. Approval creates the recurring check-in tasks.
- Care management: care tasks, RPM readings, alerts with an owner, escalations, an optional monthly QC review, and workforce scheduling and time clock.
- Remote patient monitoring: per-practice cellular device sync, CGM and home device connections approved by the patient, RPM coverage and per-patient thresholds.
- Clinical charting: QaiS drafts SOAP and encounter notes with the latest vitals and suggested ICD-10 and CPT codes; the clinician edits and signs.
- Billing: time tracking and a CPT billing ledger priced from the CMS fee schedule for each practice's MAC and locality, with Ready for Billing review and compliance checks.
- Payments: primary and secondary payer reconciliation per CPT line, and payment file import with review.
- Executive and analytics: group P&L with per-site drill-down, spend requests with recoup time, and patient, billing and revenue analytics.
- Patient portal: link sign-in, the next visit with its video link, today's plan, vitals, messages, forms, journals, medications and approved education filtered by the patient's avoid list.
- Access and records: practice scope, consent records, a PHI access log and records packets.
Book a walkthrough · See the platform