Everything You Need to Run Successful Care Programs

VitalEdge combines clinical intelligence, billing automation, and patient engagement in one unified platform designed for RPM, RTM, and CCM programs.

Clinical Workflow

Streamline clinical operations with AI-powered tools that prioritize patient care

Smart Triage Queue

AI-powered prioritization ranks alerts by clinical urgency with risk scores (0-10). Resolve alerts faster with one-click actions and bulk operations.

  • Risk scores from 0-10 based on clinical urgency
  • One-click resolve, call, or escalate actions
  • Bulk operations for efficient triage
Triage Queue
9.2
Critical BP Alert
SBP: 185 mmHg - John D.
6.5
Pain Increase
Score: 7/10 - Sarah M.
3.1
Missed Assessment
PHQ-9 overdue - Mike R.
3 alerts pending

Patient Context Panel

View complete patient history at a glance including vitals trends, medications, recent assessments, and active conditions - all in one unified view.

  • 7-day vitals trends at a glance
  • Active medications and conditions
  • Care gaps and assessment history
Patient Context Panel
JD
John Doe, 67
MRN: 10045892 | RPM + CCM
Blood Pressure (7 days)
MonToday
Active Meds
4
Conditions
HTN, DM2
Last Assessment
2 days
Care Gaps
1 open

Care Gap Detection

Automatically identify patients missing preventive care, overdue screenings, or at risk for poor outcomes. Proactive alerts help close gaps before they become problems.

  • 8 configurable rule types (HEDIS, custom)
  • Nightly automated detection runs
  • Auto-close when criteria are met
Care Gap Detection
1
Analyze Patient Data
Vitals, assessments, visits
2
Apply Clinical Rules
8 rule types • HEDIS, custom
3
Surface Gaps
Prioritized by urgency
Detected Gaps (3)
HbA1c overdue (180+ days)
Annual wellness visit due
Depression screening (PHQ-9)

Billing & Revenue

Maximize reimbursement with automated tracking and intelligent billing tools

Automated Billing Readiness

Real-time tracking of billing eligibility for RPM, RTM, and CCM. Never miss a billable patient with threshold alerts and monthly summaries.

  • Real-time CPT code eligibility tracking
  • RPM: 16+ days, RTM: 20+ minutes tracking
  • CSV export for billing teams
Billing Readiness - November 2025
47
Eligible
8
Close
$12.4k
Revenue
RPM (99454)18/16 days
RTM (99457)25/20 min
CCM (99490)17/20 min

Auto Time Tracking

Automatic start/stop timers capture clinical time with 90%+ accuracy. CPT code suggestions based on activity type ensure compliant billing.

  • Auto-start when viewing patient records
  • Activity-based CPT code suggestions
  • 90%+ time capture accuracy
Auto Time Tracking
RECORDING
12:45
Alert Review - John Doe
Today's Activities
Patient Call
8 min
Documentation
15 min
Suggested CPT99457

Patient Engagement

Connect with patients through digital assessments and comprehensive tracking

Digital Assessments

Validated clinical instruments (PROMIS, PHQ-9, GAD-7) delivered via web or mobile. Automatic scoring and trend analysis over time.

  • PHQ-9, GAD-7, PROMIS instruments
  • Automatic scoring and interpretation
  • Trend analysis over time
Digital Assessment - PHQ-9
Question 3 of 9
Over the last 2 weeks, how often have you felt tired or had little energy?
Not at all
Several days
More than half the days
Nearly every day
Current Score
12 / 27
Severity
Moderate
Progress33%

Patient Portal

Empower patients with secure access to their health data, pending assessments, and care team communication through a modern self-service portal.

  • Health summary dashboard with vitals and trends
  • Complete assessments from any device
  • View medications, history, and profile
Patient Portal - Dashboard
JD
Welcome, John
Last login: Today 9:15 AM
Latest BP
128/82
Normal
Weight
185 lbs
-2 lbs this week
Pending Tasks
PHQ-9 Assessment
Due today
Meds
Vitals
Profile

Clinical Intelligence

Evidence-based recommendations and care pathway orchestration powered by clinical data

Clinical Decision Support

Get real-time, evidence-based recommendations from 8 clinical categorization services. AI-powered insights surface the right guidance at the right time.

  • 8 clinical categorization services (BP, Diabetes, HF, COPD, etc.)
  • Care pathway orchestration with step tracking
  • Priority-ranked recommendations in context
Clinical Decision Support
JD
John Doe • HTN, DM2
Recent BP: 158/95 mmHg
HIGH PRIORITY
Stage 2 Hypertension
Consider medication adjustment. BP consistently above 140/90 for 3+ readings.
RECOMMENDATION
Diabetes Management
HbA1c due in 2 weeks. Consider dietary review.
Active Care Pathway
60%
Hypertension Management Pathway

More Powerful Features

Smart Documentation

Pre-built templates for encounter notes, progress summaries, and care plans. Auto-populate from patient data.

Revenue Analytics

Comprehensive dashboards showing billing trends, reimbursement rates, and revenue projections.

Observation Tracking

Capture vitals, symptoms, and patient-reported outcomes from any source - manual entry, device sync, or patient self-report.

Multi-Language Support

Reach diverse patient populations with full internationalization. Available in English, Spanish, German, and more.

Medication Management

Track prescriptions, adherence patterns, and drug interactions with integrated NDC database.

CSV Export & Reports

Export billing summaries, patient lists, and audit logs in standard formats for compliance and review.

Prior Authorization Hub

Streamline prior auth workflows with X12 EDI transactions, Availity/Change Healthcare integration, and real-time status tracking.

Patient Portal

Give patients secure access to view health summaries, complete assessments, track medications, and message their care team.

Clinical Decision Support

Evidence-based recommendations from 8 clinical categorization services with care pathway orchestration.

Security & Compliance

Enterprise-grade security built from the ground up for healthcare

HIPAA Compliant

Enterprise-grade security with end-to-end encryption, role-based access control, and comprehensive audit logging.

Audit Trail

Complete record of all system activity including who accessed what data and when.

Multi-Factor Auth

TOTP-based MFA, backup codes, and social login options for enhanced security without friction.

Role-Based Access

Granular permissions for clinicians, nurses, billing staff, and administrators.

Seamless Integrations

Connect VitalEdge with EHRs, RPM devices, and clearinghouses through our FHIR R4 API and pre-built integrations.

F
HL7 FHIR R4✓ LiveFull read/write API
O
Omron✓ LiveBP & weight devices
T
Tenovi✓ LiveRPM device suite
A
Availity✓ LiveEligibility & auth
C
Change Healthcare✓ LiveX12 EDI transactions
E
EpicReadyVia FHIR R4 API
Ce
CernerReadyVia FHIR R4 API
G
Google FitPlannedComing soon
H
Apple HealthPlannedComing soon

✓ FHIR R4 API live with full read/write operations for Patient, Observation, Condition, and Medication resources

EHR integration ready via FHIR R4 - customer configuration required for Epic/Cerner

Ready to Transform Your Care Programs?

Join healthcare organizations that have increased billing capture by 40% and reduced clinical workload with VitalEdge.