Stop Payment Problems Before the First Claim: FairPath's Three Checks for Remote Care
A denied claim arrives after your team has already done the work. Use three connected checks to catch avoidable enrollment and payment problems earlier.
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Operational guidance and analysis for APCM, RPM, RTM, and value-based care execution.
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Who Can Bill Remote Patient Monitoring—and Who Can Perform the Clinical Work?
A physician or other QHP bills Medicare RPM and remains accountable for the claim. Eligible clinical staff may perform qualifying treatment-management work under current supervision and incident-to rules, while CMS has only proposed a direct-employee restriction for 2027.
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CCM Compliance Is Becoming an Analytics Problem
OIG's new CCM audit focus shows why practices and pharmacy partners need pre-claim intelligence that connects eligibility, care plans, evidence, overlap checks, and billing readiness before claims go out.
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We Ran the New HHS Medicaid Data Through Our AI. Here’s What We Found in RPM Billing
We loaded the newly released HHS Medicaid provider spending file into FairPath and analyzed Remote Physiological Monitoring (RPM) codes. Here are the geographic hotspots and billing patterns that stood out.
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RTM for medication adherence: what it is, how it differs from RPM, and how pharmacies can run it
RTM is one of the cleanest ways for pharmacies to build a reimbursable clinical services line because medication adherence is already your surface area. This guide explains what RTM is, how it differs from RPM, and how to run an adherence program at scale without manual cleanup.
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APCM “Year-End Reporting” Is Not Hard. Reconstruction Is.
By Justin Brochetti, CEO of Intelligence Factory & FairPath | January 20, 2026 Originally Published: https://fairpath.ai/resources/apcm-reporting
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The Plain-English Insurance Era Is Dawning: Why Practices Need Plain-English Operations to Thrive
You've likely caught the buzz on X and news feeds about President Trump's "The Great Healthcare Plan" framework, released today (January 15, 2026). Per the official White House fact sheet, it calls for insurers to publish "plain-English" comparisons of rates, coverage, denial ra…
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Medicare's $4.5 Billion Wake-Up Call: What the VBID Sunset Reveals About Risk, Equity, and the Next Era of Value
In a single December blog post, CMS just rewrote the playbook for $400 billion in annual Medicare Advantage spending. The termination of the Medicare Advantage Value-Based Insurance Design (VBID) Model (after it generated $4.5 billion in excess costs over two years) isn't just a…
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One Biller, One Gap: How a Missing Piece Reshapes Everything
There’s a quiet agreement most of us make in business. It’s not in a contract. It’s not written on a whiteboard. But it runs everything: trust. We trust that what worked yesterday will still work tomorrow. We trust that people we’ve known for years will keep showing up the way…
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The System Is Rigged: How AI Helps Independent Docs Fight Back
Feeling like you’re drowning in regulations designed by giants, for giants? If you're running a small practice in today's healthcare hellscape, it damn sure feels that way. And maybe "feeling" isn't the right word – maybe it's just reality.
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Million Dollar Surprise
“They’re going to put me out of business. They want over a million dollars. I don’t have a million dollars”, his voice cracked over the phone.
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