Commonly Asked Questions (FAQ)

Below are answers to common questions about unexpected situations you may encounter as a clinic supervisor or therapist.

For additional questions or concerns, please refer to other sections of this document or contact [email protected]

Patient Cost & Coverage

Q: Is there a copay or deductible for RTM services?

RTM is not considered an in-office visit, so standard visit copays do not apply.

RTM is considered a therapy-related service and is subject to deductible rules. If you prefer not to enroll patients with remaining deductibles, simply let us know. We can limit RTM enrollment to patients whose deductibles are already met or who have no deductible.

Q: How does billing and reimbursement work?

RTM billing is tracked on a monthly cycle. Near the end of each month, clinics review billing progress in the Balance page and complete the required e-signature. Once approved, PhyxUp Health submits claims on the clinic’s behalf.

RTM claims are billed under your clinic’s NPI. If your clinic has EFT set up with payers, reimbursements are deposited directly into your clinic’s bank account. PhyxUp Health tracks payments and provides a payment report so you can clearly see claim status and reimbursement amounts.

During the billing cycle, clinics can choose their preferred billing method:

• Through your EMR, allowing you to track claim status directly
• Outside your EMR, where PhyxUp Health submits claims through payer portals or clearinghouses to keep RTM billing separate

We’ll align the process with what works best for your clinic.

Q:Which insurance plans support RTM?

RTM coverage varies by payer, plan, and state. Common payers include Medicare, BCBS, UnitedHealthcare, Aetna, Cigna, Humana, Clover Health, Tufts Health, and others. PhyxUp Health performs eligibility checks for each patient before enrollment to confirm coverage.

Fully Managed RTM Service

Q: What responsibilities does PhyxUp Health handle for my clinic, and what responsibilities remain with the clinic?

Under the Fully Managed RTM Service, PhyxUp Health manages:

• Insurance eligibility checks
• Patient onboarding
• Remote therapist monitoring & documentation
• Billing spreadsheet preparation & claim submission.

Clinics remain responsible for delivering in-person care, confirming patient consent, approving clinical decisions when required, and reviewing and signing monthly billing reports.

Q: Can I onboard patients prior to their first visit?

Yes. You can register patients on the platform prior to their first visit to the clinic, but the RTM service and billing period will not start until the patient has had their first visit.

PhyxUp Health integrates with your EMR system to securely retrieve any additional required information.

Q: Can the remote therapist workflow be customized for my clinic?

Yes. While all remote therapists receive standardized training, workflows can be customized to align with your clinic’s preferences. This may include call schedules, HEP approval requirements, or reporting workflows. Customization requests can be submitted to [email protected]

Clinical Oversight & Communication

Q: If a patient reports new symptoms or concerns to the remote therapist, how will our clinic know?

PhyxUp Health provides regular reports and updates to your clinic. Any important patient-reported symptoms, concerns, or red flags identified by the remote therapist are shared with your team so you remain informed and involved in clinical decisions.

Q: Who manages the exercise program?

PhyxUp Health can fully manage exercise programs. If your clinic has preferred exercise templates, you can share them with us, and we’ll build them into the RTM platform for your patients.

Alternatively, your clinic can provide the initial exercise program, and remote therapists can follow up, monitor adherence, and update exercises based on patient feedback. The workflow is fully customizable.

Q: WHow often are patients checked in on?

Remote therapists continuously monitor patient data through the dashboard. Phone calls are typically scheduled once per week. If your clinic prefers more or fewer touchpoints, we can adjust the frequency to match your preferences.

Q:What types of patients are a good fit for RTM?

RTM can be applied to patients of all ages and diagnoses, as long as clinical judgment supports remote monitoring.

That said, RTM may be particularly helpful for:

• Patients with low engagement or frequent cancellations
• Patients seen once weekly or biweekly
• Patients who would benefit from additional accountability and follow-up

Final enrollment decisions remain with the clinic.