Informed Consent for Remote Monitoring

The Heartbeat Clinic

Informed Consent for Remote Monitoring

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You have signed up for Remote Monitoring, or a “home monitoring” device. This home monitor will be assigned to your specific device and will be shipped to your home address on behalf of The Heartbeat Clinic or given to you at your device implant.

When the monitor comes to you, there will be a toll-free number to call for technical set- up support at 866-470-7709. The device company tech support will walk you through setting up your monitor. You will be asked to send in an initial transmission of device data to establish your account. Our THBC device nurse can access your transmission through a secure, password protected web server. Once the monitor is set up and the initial transmission is sent, please call us after 15 minutes to assure you we received the transmission at 214-504-9942 ext 252.

______An Annual Office Visit is required if THBC is following your monitor in remote clinic. If you have an ILR, ICD or Pacemaker, you are required to see a THBC physician in the office or via tele-visit at least once a year.

______If you are experiencing any problems that feel related to your heart, arrhythmia, or your device, we encourage you to send a transmission and call THBC. If data is sent via remote monitoring and there are clinical issues that need to be addressed, we will call you to review and will schedule an appointment immediately if appropriate.

Reviewing your Device Data
  • Your Device Data will be sent to a secure central server where our clinic staff can view it, using a password protected website on the internet.
  • Our office reviews device data every business day.
  • Our office will not see data sent on Saturday or Sunday until Monday morning, unless marked as urgent on our secure website.
  • You should not use the monitor to send device data to us unless you are scheduled to do so, experiencing a problem, or if you have been instructed to do so by THBC.
  • Please do not send transmissions daily or weekly unless instructed to do so by THBC.

______After we review your data, if there are any clinical issues that need to be addressed, we will contact you. We will NOT contact you following a normal interrogation; however, you may call us if you have any questions/concerns.

______Insurance and Co-Pays

Our Clinic will bill your insurance company only once during each remote monitoring interval period regardless of how many transmissions we receive. For example, if your device sends us 20 transmissions over a 91-day billing interval, we will only bill the insurance company once. If you currently have a CoPay when you have a clinic visit, we anticipate that you might be billed the same Co-Pay for your remote transmission. Please note that office billing and remote monitor billing are independent of each other. If you have questions regarding how your insurance will pay for the remote monitoring visit, please contact your Insurance Company. Your insurance company will ask for CPT codes to quote the charges:
Codes for a Pacemaker Remote Transmission – CPT Code 93294 & 93296
Codes for a Defibrillator Remote Transmission – CPT Code 93295 & 93296
Codes for a LINQ / Confirm / ILR Remote Transmission – CPT Code 93299 & 93298
Codes for ICM/ Intracardiac Heart Failure Remote Transmission- CPT Code 93297

** Legal Disclaimer – These codes are subject to change based on CMS guidelines **

Pacemaker & Defibrillator Remote Monitoring Billing Interval is 91 days
Implantable Loop Recorder Remote Monitoring Billing Interval is 31 days
ICM Remote Monitoring Billing Interval is 31 days

I have read and understand the TCA Remote Monitoring Department Office Policies:

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If you have an emergency, call 911 or follow your doctor’s instructions. If you receive a shock from your defibrillator, please call THBC ASAP.

Traveling and the monitor
If you will be away from home for a long period of time, you can take your monitor with you. Please note that the monitor works within the continental United States, Alaska and Hawaii. Please provide an alternate contact number for the clinic to contact you if necessary.

If you have any questions about your implanted device or these guidelines, please contact your nurse. Our business hours are Monday-Thursday 9am-5:00pm and Friday 9am-12pm.