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ITAS Health

For practice managers & office managers

You are the person this either works for or does not.

Whoever else signs the contract, you are the one who will run enrollment, field the copay call, chase the device that stopped transmitting, and close the month. So here is the version without the pitch: what lands on your desk, what leaves it, and what to say.

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A nurse on a patient call with an open paper chart at a clinic desk

The monthly reality

What your team does, and what stops being your problem

Stays with your team

  • The enrollment conversation

    Best had at the annual wellness visit, by someone the patient already trusts. We give you the script and the tier information; you have the relationship.

  • Capturing consent

    Verbal is fine. The disclosure language is scripted and the capture is two fields, but a person has to actually say it to the patient.

  • The clinical calls

    Your nurse or MA makes the live touchpoints. That is the part Medicare is paying for, and under the CY2027 proposal it is the part that has to be your staff.

  • Answering the front-desk question

    Scripted, but human. One good answer at the counter prevents most disenrollments.

Stops being your problem

  • Working out who qualifies

    The panel is screened against each program's criteria and returned as a list with tiers already assigned. No chart-by-chart review.

  • Counting transmission days

    Reconciled from the device feed, per patient, per period. Nobody tallies anything in a spreadsheet.

  • Chasing documentation before the claim

    Notes, time logs, and the interactive-communication record assemble as the work happens. Months that are short are flagged with the reason.

  • Device logistics

    Preconfigured cellular devices ship to patients directly. Replacements and returns run on the same rail.

  • Wondering whether someone else is billing it

    Eligibility and claims cross-checks catch the single-biller conflict before the claim goes out rather than after a denial.

The conversation everyone dreads

The copay is not the obstacle. Surprise is.

Practices that abandon care-management programs almost always abandon them in month two, after the first statement generates calls. That is a sequencing problem, and it is fixable.

At the wellness visit

Medicare has a monthly program for patients managing more than one ongoing condition — we check in between visits, keep an eye on things, and coordinate with your other doctors. Most patients pay about eleven dollars a month for it, and for some patients it's nothing at all. You can stop any time. Would you like me to look up which applies to you?

When the first statement lands

That's the monthly care-management program you enrolled in at your wellness visit — the check-in calls and the coordination between appointments. Would you like me to go over what it includes, or would you rather stop it?

Scripts are starting points, not compliance documents. Adapt them to your practice, and confirm cost-sharing amounts for your locality before quoting a figure to a patient.

~$11
Typical monthly patient coinsurance
20% of the CY2026 G0557 national average of $53.78, after the Part B deductible. Varies by locality and supplemental coverage.
$0
What a Qualified Medicare Beneficiary pays
QMBs may not be billed Medicare cost-sharing at all — and this is the tier that reimburses the practice the most. Knowing who is in it before you have the conversation changes the conversation.
Any time
When a patient can stop
Disclosed at consent, honoured immediately, recorded. Offering the exit is what keeps enrollment durable.

The monthly close

Three states, and none of them is a mystery

At any point in the month, every enrolled patient sits in exactly one of these — with the reason attached.

  1. 01

    Clear

    Every gate satisfied. Order signed, consent on file, day count reconciled, touchpoint logged, documentation assembled. The claim is prepared with its evidence file attached.

    Your action: submit.

  2. 02

    Held, with a reason

    Something specific is missing and it is named: consent not captured, no live touchpoint yet, day count short of the threshold. Fixable while the month is still open.

    Your action: go get the missing thing.

  3. 03

    Not billable this month

    The patient genuinely did not receive the service, or the count does not support a code. The month closes unbilled, which is the correct outcome and the one that keeps you defensible.

    Your action: none. That is the point.

Practice manager questions

The operational ones

How do I explain the copay without losing the patient?
By raising it first, at the wellness visit, in the same breath as the benefit — and by knowing which tier the patient is in before you open your mouth. Qualified Medicare Beneficiaries owe nothing at all. For everyone else it is roughly $11 a month at G0557 national rates, after the deductible. Patients who hear the number from you rarely object. Patients who discover it on a statement almost always do.
What happens when a patient calls about the charge anyway?
Your front desk gets a scripted answer: that it is the monthly care-management program they enrolled in at their wellness visit, and would they like to review it or stop it. Offering the exit is what keeps the program from becoming a complaint. Patients can stop at any time, and that was disclosed at consent.
Who ships the devices and handles the ones that break?
We do. Devices ship preconfigured directly to the patient and transmit on their own cellular connection, so nobody on your staff is reading a Wi-Fi password out over the phone. Replacements and returns run through the same path. Your team does not become a hardware help desk.
How much time will this take my staff each month?
We would rather scope that against your panel than quote a number. The honest framing: the work that disappears is chasing, counting, and documenting. The work that remains is talking to patients, which is the part your team is actually good at and the part that has to be human.
What if a patient stops using their device?
You will know while there is still time to do something, not at the end of the month. Drifting transmission counts become outreach tasks before the threshold is missed, and if a patient has genuinely disengaged, the period resolves to whatever code the actual count supports — or to nothing at all, which is the correct answer.
Do I have to learn a new billing system?
No. Claims are prepared for the workflow you already use and submitted by your practice under your own NPI. We are not a clearinghouse and we do not touch your money.

Your physician will want the clinical version, which answers a different set of questions.

Thirty minutes with you, zero with your physicians

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