Frequently Asked Questions

KaiCare Ai is a full-service healthcare technology partner that enables medical practices to deliver Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) programs without adding any burden to their existing staff.

Our proprietary platform, combined with a dedicated clinical team, handles everything end-to-end from patient eligibility analysis and enrollment to ongoing monitoring, AI-powered interventions, and revenue support.

Our mission: Empowering providers. Equipping patients. Elevating outcomes.

KaiCare Ai partners with a wide range of practices from primary care and internal medicine to specialty clinics and large multi-provider groups.

Any practice that manages patients with chronic conditions such as hypertension, diabetes, COPD, heart failure, or behavioral health conditions is an excellent fit for our RPM and CCM programs.

We work across payer types including Medicare, Medicaid, commercial insurers like BCBS and UnitedHealthcare, and VA/Veterans programs.

It is our guiding principle. Traditional healthcare relies on in-office visits, but most of a patient’s health journey happens at home.

KaiCare Ai bridges that gap by enabling continuous monitoring, proactive clinical support, and intelligent interventions wherever the patient is.

We help shift care from reactive to intelligent, predictive, and connected.

RPM uses connected medical devices such as blood pressure monitors, glucose meters, and pulse oximeters to collect patient health data from home.

That data is transmitted to our platform where KaiCare Ai’s clinical team reviews vitals, monitors trends, and communicates with patients.

Providers are alerted only when clinical intervention is needed, enabling earlier and smarter care decisions.

CCM is a CMS-recognized program for patients with two or more chronic conditions expected to last at least 12 months.

It involves non-face-to-face care coordination, medication management, care plan oversight, patient communication, and coordination between providers.

KaiCare Ai’s clinical staff performs these services under the general supervision of the billing provider, supporting adherence to the physician-prescribed care plan.

Yes. RPM and CCM can be billed for the same patient in the same month, as long as the time and effort documented for each service is separate and distinct.

You cannot count the same minutes or activities toward more than one program.

KaiCare Ai’s platform automatically tracks time per program to ensure compliance.

Note: RPM and RTM cannot be billed together for the same patient.

Yes. In addition to RPM and CCM, KaiCare Ai supports Principal Care Management (PCM) and Remote Therapeutic Monitoring (RTM).

PCM is designed for patients with a single high-risk chronic condition, while RTM extends remote monitoring to non-physiologic data such as therapy adherence and musculoskeletal outcomes.

Our platform and clinical team can manage all four programs simultaneously for maximum clinical and financial impact.

Our end-to-end process has five phases:

1. Patient Eligibility - We analyze your existing patient census and deliver a report showing how many patients qualify for RPM, CCM, and related programs.
2. Enrollment - We handle informed consent, device shipping, and personally walk each patient through device setup.
3. Ongoing Monitoring - Our clinical team reviews vitals and supports care plan adherence while the platform tracks time and data automatically.
4. Smart Interventions - AI-powered alerts flag abnormalities and notify the provider only when clinical action is needed.
5. Revenue Support - The platform documents every billable interaction. We deliver monthly billing reports ready for claim submission.

Your team stays focused on patient care. We handle the rest.

No. KaiCare Ai is designed for zero practice burden.

We function as a seamless extension of your practice, handling patient communication, device coordination, monitoring, and documentation.

Your staff never takes on additional tasks or learns new workflows.

No manual charting, no chasing data, no administrative backlog.

Our platform tracks interactions, captures time, and generates documentation in real time so your practice runs leaner, not busier.

Our AI works behind the scenes to analyze incoming patient data, identify trends, and flag abnormalities before they become emergencies.

It enables our clinical team to focus on what matters most and ensures that providers are alerted at exactly the right moment, with the right information.

The result is not just information, but insight; not just data, but direction, enabling meaningful clinical decisions before issues escalate.

KaiCare Ai employs a dedicated team of Medical Assistants (MAs) who review incoming vitals, monitor symptom trends, and proactively support each patient’s adherence to their physician-prescribed care plan.

Our MAs operate within the KaiCare Ai platform daily, ensuring consistent, high-touch monitoring delivered at scale.

Behind every alert is a real person. Your patients are never just a data point.

Our platform supports documentation and billing for CMS-approved RPM and CCM codes, including:

• RPM: 99454 (device supply, 16+ days), 99445 (device supply, 2-15 days), 99457 (treatment management, first 20 min), 99458 (each additional 20 min), and 99470 (treatment management, 10-19 min).
• CCM: 99490 (base 20 min), 99439 (each additional 20 min), and 99487 (complex CCM, 60 min of clinical staff time).

Note: CPT codes 99445 and 99470 are new 2026 codes that expand billing flexibility for RPM services. Our platform stays current with CMS updates so your practice captures every eligible dollar.

Revenue depends on your patient volume and payer mix.

As an example, a practice with 1,000 eligible patients enrolled in RPM and CCM could generate approximately $340,000+ per month at Medicare rates.

Practices with a strong commercial insurance mix such as BCBS and UnitedHealthcare often see rates 20-40% higher than Medicare baseline.

KaiCare Ai provides a customized revenue proforma during our eligibility analysis so you see your specific opportunity before committing.

KaiCare Ai’s platform documents every billable interaction with detailed accuracy in real time.

At the end of each billing cycle, we deliver a comprehensive monthly billing report that is ready for claim submission.

Your billing team simply submits the claims with no additional documentation or chart review required.

The revenue is billed under your practice’s NPI, and reimbursements come directly to your practice.

Built around CMS-approved CPT codes, this creates a predictable, recurring monthly revenue stream.

During an active 30-day TCM service period, RPM can be billed alongside TCM, but CCM cannot.

Once the TCM period ends, billing for both RPM and CCM can resume freely.

Key rules:

• The time and effort documented for each program must be separate and distinct.
• RPM and RTM can never be billed together for the same patient.

Our platform enforces these rules automatically to keep your practice compliant.

Medicare is the primary payer and typically reimburses at established national rates.

Most major commercial insurers including Blue Cross Blue Shield, UnitedHealthcare, Aetna, and Cigna also cover RPM and CCM services, often at rates 120-140% of Medicare.

Medicaid coverage varies by state, and VA/Veterans programs also reimburse for these services.

During our eligibility analysis, we evaluate your specific payer mix so you have a clear picture of expected reimbursement.

Yes. Informed patient consent must be obtained before any services begin.

For RPM and RTM, written signed consent is required.

For CCM and PCM, verbal consent is acceptable under CMS guidelines, though written consent is always preferred.

KaiCare Ai handles the entire consent process during enrollment, and all documentation is filed in the patient’s medical record.

Our consent forms comply with HIPAA, federal and state telehealth regulations, and CMS requirements.

The physician or qualified healthcare professional at your practice is always the billing provider of record.

This includes MD, DO, NP, PA, CNS, and CNM roles.

KaiCare Ai’s clinical staff performs services under their general supervision, meaning the provider directs the care but does not need to be physically present.

Only one practitioner may bill for CCM or RPM services for a given patient in a calendar month.

Our platform is built around CMS guidelines from the ground up.

It automatically tracks time per program to prevent double-counting, enforces billing rules such as TCM exclusion periods and RPM/RTM mutual exclusivity, and documents every patient interaction in real time.

Monthly billing reports include detailed line-item accuracy per CPT code, per patient, per payer so your claims are clean and defensible.

We stay current with annual CMS updates, including new 2026 CPT codes.

Absolutely. KaiCare Ai’s platform and operations are built to meet all HIPAA privacy and security requirements.

Patient health data is transmitted, stored, and accessed in compliance with federal regulations.

Our consent process, clinical workflows, and documentation practices all follow established standards for telehealth and remote care delivery.

Not at all. You control your enrollment pace entirely.

Start with a small group of patients, see the results firsthand, and expand as you grow more confident.

There is no minimum enrollment requirement and no pressure to hit specific timelines.

Whether you begin with five patients or five hundred, our team is ready to support you at whatever speed works best for your practice.

KaiCare Ai is built to scale with you from pilot to full implementation on your terms.

From day one, providers receive full access to our portal and the ability to roll out KaiCare Ai services to their practice and patients at their chosen pace.

There are no upfront costs to the provider or practice, and billing only occurs when the provider or practice submits claims for enrolled patients who have generated billable services.

There are no setup costs, equipment purchases, or hidden charges.