The Operating Layer for Evidence-Based Care
VitalEdge connects clinical evidence, encounter context, and care delivery into one operating layer for quality, compliance, and value-based care.
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Healthcare already has the data. It lacks continuity.
What was observed, documented in the encounter, acted on, measured for quality, and reviewed for compliance often lives in different systems. VitalEdge connects those layers.
Not another point solution. A shared operating layer across care programs, evidence, quality, and compliance.
One Architecture, Every Layer of Care
Clinical evidence flows through the platform once — and powers care delivery, quality, and compliance from the same record.
Built for the way organizations operate care — Practices · FQHCs · Health Systems · MSOs · ACOs
The Programs Your Care Teams Already Run — Finally on One System
Five CMS care programs, one evidence and encounter architecture underneath — not five different tools stitched together.
Remote Patient Monitoring
Track vital signs and chronic conditions with automated device data collection. Bill CPT 99453, 99454, 99457, 99458 — plus the new 2026 short-duration codes 99445 and 99470.
- Blood pressure monitoring
- Glucose tracking
- Weight & vitals
Remote Therapeutic Monitoring
Monitor therapy adherence and pain management outcomes. Bill CPT 98975, 98976, 98977, 98980, 98981 — plus the new 2026 codes 98985 and 98979.
- Pain assessments
- PROMIS validated scales
- Therapy adherence
Chronic Care Management
Coordinate care for patients with 2+ chronic conditions. Bill CPT 99490, 99491, 99439, 99437 — with the 2026 ~10% rate uplift on 99490/99439.
- Care plan management
- Time tracking
- Multi-provider coordination
Principal Care Management
Dedicated care planning for one serious, high-risk chronic condition. Bill CPT 99424, 99425, 99426, 99427.
- Single-condition care plan
- Clinical + physician time tracked separately
- Runs alongside RPM/RTM enrollments
Behavioral Health Integration
Coordinate behavioral health treatment alongside physical care, on the same record. Bill CPT 99484.
- Behavioral care management
- Shared evidence with physical-health programs
- Care-team messaging that counts as billable time
Everything You Need for Value-Based Care
Built by clinicians, for clinicians. Every feature designed to reduce administrative burden and improve patient outcomes.
Smart Triage Queue
Prioritized alert management with risk scoring. One-click actions and bulk operations cut the time spent working a queue.
Automated Billing
Real-time billing readiness tracking. Automatic CPT code suggestions based on documented time and activities.
HIPAA Technical Safeguards
Encryption in transit and at rest, comprehensive audit logging, and role-based access controls.
Clinical Analytics
Population health insights, trend analysis, and outcome tracking. Make data-driven care decisions.
Care Gap Alerts
Proactive identification of care gaps. Never miss a required assessment or follow-up again.
Multi-Language Support
Serve diverse patient populations with English, Spanish, German, and more language options.
Device Integrations
Adapters for Omron and Tenovi RPM devices, ready to activate for automatic blood pressure, weight, and glucose data sync.
Prior Authorization
Streamline prior auth with X12 EDI transactions, clearinghouse integrations, and real-time status tracking.
Quality Measure Reporting
Track 18 measures across HEDIS, MIPS, and CMS Star Ratings out of the box. MIPS composite scoring with payment-adjustment estimates and nightly population calculations.
Clinical Intelligence Under the Hood
Clinical evidence isn't just data. VitalEdge keeps every observation, condition, and document connected to the encounter and provider behind it — so the same record that satisfies a review also drives care.
Condition-Specific Dashboards
Eight categorization engines — blood pressure, diabetes, heart failure, COPD, asthma, AFib, chronic pain, and autism — turn readings into status, trends, and guidance.
Patient-Carried PHR + QR
Patients carry their full record and hand it to any provider via a revocable, audited QR code — with a FHIR download and surfaced billing opportunities.
FHIR R4, Read & Write
Read/write for Patient, Observation, and MedicationStatement; read access to Condition, Practitioner, and Medication — with idempotent, sync-safe EHR imports.
Eligibility & Prior Auth
Real-time eligibility (X12 270/271) and prior authorization through Availity and Change Healthcare clearinghouses.
Medication Reconciliation
Compare what the pharmacy dispensed against what was documented — catching undocumented medications and abandoned prescriptions that self-report never surfaces.
Funder & Network Reporting
Attribute enrollments to the grant or sponsor that funded them, then hand that funder a revocable, de-identified snapshot of exactly the cohort they paid for.
Communication That Bills
Secure patient messaging with clinician time captured as CCM minutes, plus attested live touchpoints that gate the RPM/RTM codes CMS requires them for.
Caregiver-First Life Plan
A durable plan authored by the family — published to the care team in versioned snapshots, with per-section control over what the patient sees.
Know the Context, Not Just the Data
Every condition, observation, medication, and procedure resolves back to the encounter it came from — the visit, the provider, the date, the setting.
AI That Stays Inside the Evidence
Patients can ask their care navigation assistant to explain a result, check what's due, or see what they qualify for — and every answer is checked against their own record before it's shown.
- Grounded strictly in the patient's own data — never a general medical chatbot
- Descriptive, not diagnostic — it explains the record, it doesn't give clinical advice
- Hands off to the care team the moment a question needs clinical judgment
Built to Be Reviewed
Every result traces back to the evidence, encounter, and provider behind it — VitalEdge is built to make clinical operations traceable, not just to record them.
Seamless Integrations
Connect with leading healthcare systems, devices, and clearinghouses
Built for the Way Billing Teams Work
VitalEdge doesn't just monitor patients — it turns care activity into coordinated, measurable, operationally usable work. Capturing the RPM, RTM, CCM, PCM, and BHI revenue you've already earned is one output of that, not the whole platform.
Know who's billable — and who's close
Every patient is sorted into billable, almost-there, or not-yet against the exact CMS thresholds, with the specific gap to close for each one.
Stop reconciling spreadsheets by hand
Device days and clinical-time minutes are tracked per enrollment, so billing readiness is calculated for you instead of audited line by line.
Current with CMS rules
CPT eligibility reflects the 2026 fee schedule — including the new short-duration RPM and RTM codes — so you bill what you can, correctly.
Pilot programs are underway. Customer stories coming soon.
Built for Every Care Setting
FQHCs
Requirement tracking, obligation status, and evidence linkage alongside the same RPM, RTM, CCM, and BHI capabilities every VitalEdge organization runs on.
Talk to our teamEnterprise & MSOs
Multi-tenant governance, configurable policies per site, and centralized visibility into quality and compliance — standardized across every practice you operate.
Talk to our teamBuilt for What's Next
The same clinical evidence and encounter architecture that runs care operations today is designed to support increasingly sophisticated clinical intelligence over time.
See Your Care Operations as One System
Evidence, encounters, care delivery, quality, and compliance — and yes, exactly which patients are billable this month.