Replacements, returns, and offboarding
Swap a lost or broken device, return hardware to inventory, and cleanly retire a device when a patient is discharged.
Devices move through five lifecycle states in the staff portal: Active, In Maintenance, Returned, Lost, and Retired. The portal enforces the state machine: for example, a Retired device cannot be reactivated, and a Returned device must be sanitized before it can be reissued. Use the workflows below to keep the inventory clean and the billing record correct.
Replacing a lost or broken device
A device is "broken" if it produces error 14 (abnormal certification), fails three consecutive firmware updates, has visible damage, or has been silent for more than 14 days despite the patient confirming it is plugged in and powered. A device is "lost" if the patient cannot find it after a documented two-week search.
Open Devices, find the row, and click Return in the Actions column. A modal opens.
Pick a Condition:
- Damaged: physical damage, visible cracks, water exposure.
- Needs Repair: firmware-stuck or one of the persistent device error codes (11, 14).
- Defective: hardware fault you cannot pin down.
- Good: the device works fine, the patient just no longer needs it.
For a lost device, set Condition: Damaged and put "Lost. See note" in the Reason field.
Add a short reason: for example, "Cuff bladder leaks during inflation, patient reports incomplete readings." This text is saved in the device's notes and shows up in Activity.
Click Return Device. The device's lifecycle moves to Returned, the patient is automatically unassigned, and the row drops out of the Active filter.
Open the patient's chart at Patients -> select patient -> Devices and click Assign new device. Pick a fresh device from the Unassigned pool and follow the pairing flow.
Replacing a device does not restart the patient's monthly monitoring counter. If the patient already has 10 valid days this month, the new device picks up the count from day 11. The 16-day threshold for CPT 99454 is per patient per calendar month, not per device.
Sending the old device back
Once the row shows Lifecycle: Returned, your shipping or inventory team takes over. The portal's Activity tab on the device record keeps the audit trail: who returned it, when, with what condition, and the reason text you entered.
If the device is repairable, the admin will move it from Returned to In Maintenance while it ships to the manufacturer. When it comes back clean and tested, they'll move it to Active and back into the Unassigned pool, where it is eligible to ship to a new patient.
If the device is irreparable or the warranty has expired, the admin will move it to Retired, a terminal state. The serial number remains in the database for audit purposes but the device cannot be reissued.
Handling returns from discharged patients
When a patient is discharged from the RPM program (graduation, transfer of care, or non-engagement), the device must come back to inventory the same calendar month so it can be reissued without billing overlap.
Mark the patient as discharged in Patients -> select patient -> Status. This stops new alerts from generating but does not automatically unassign devices.
Mail the patient a return shipping label. Most clinics include a pre-addressed prepaid envelope in the original shipment for this purpose.
When the device arrives, open Devices, find the row, and click Return. Set Condition: Good if it powers on, takes a test reading, and has no visible damage. Add a reason like "Patient graduated from program."
Sanitize the device per your clinic's infection-control protocol before it goes back into the Unassigned pool.
If a discharged patient never returns the device, mark it Returned with Condition: Damaged and the reason "Non-return. Patient lost to follow-up." This pulls the device out of the active count for billing and inventory reports without inflating your damage rate.
Offboarding workflow at a glance
Use this sequence whenever you close out a patient:
- Resolve open escalations. Any pending or acknowledged escalation for the patient needs to land in Completed before discharge. See Escalations.
- Close the billing month. Confirm in Billing -> Periods that the current month's CPT codes have either captured or been waived with a note.
- Unassign the device. Either click Unassign on the row in Devices (keeps the device in inventory under your tenant) or use Return (sends it back to the platform pool for redeployment).
- Update patient status. Move the chart to Discharged in Patients.
- Document the reason. Add a note in the patient's chart so the next clinician to look at the record understands why.
A clean offboard takes about three minutes per patient. Skipping any step risks orphaned devices, false alerts, or lost billable time.