Offboard a patient

Patients leave RPM for plenty of reasons: their condition is well controlled, they switched practices, their insurance changed, they asked to stop, or (sadly) they passed away. Offboarding cleanly is important for two reasons: you stop accruing time you can't bill for, and you make sure the patient's last month of care is captured on the final claim.

Decide: pause or discharge?

Before you offboard, decide which case you're in:

Temporary pause (hospitalization, travel, insurance gap): use Mark inactive. See Managing patients. The patient keeps their device and history.
Permanent discharge (no longer in your panel, no longer eligible, patient request, deceased): follow this page.

1. Document the discharge reason

Open the patient profile and click Status -> Discharge from RPM.

Pick a Discharge reason: Goal achieved, Patient request, Provider decision, Insurance ineligibility, Transferred to another practice, Deceased, or Other.

Enter a brief Discharge note. A sentence or two explaining the clinical context. This is part of the permanent record.

Set the Effective discharge date. Defaults to today; you can backdate to the actual last-care date if needed (e.g., if the patient died last week and you're documenting now).

Click Continue. Vantrexia stops generating new alerts for the patient and freezes their threshold and device configuration as of the discharge date.

If the discharge reason is Deceased, also tick the Deceased flag on the Demographics card. This is the FHIR-standard signal that prevents the patient from ever appearing in active panels again, even if someone tries to reactivate them.

2. Retrieve the device

Devices are reusable. Get yours back so you can reassign it to the next patient.

From the patient profile, open the Devices tab and click Unassign next to the device.

Pick a return reason: Patient discharged, Patient returned device, Lost, Damaged, Deceased.

If you want the patient to mail the device back, click Send return kit. Vantrexia generates a prepaid return label and triggers an email or SMS to the patient with shipping instructions.

Once the device is physically back at your clinic, open Devices -> Inventory, find the unit, and click Mark received. The device is now eligible for assignment to a new patient.

Don't unassign a device until the discharge effective date has passed and you've confirmed there are no late readings still in flight. Unassigning early can drop the patient below the 16-day threshold for that month's 99454 claim.

3. Run the final claim

This is the part new clinics tend to get wrong. RPM is billed monthly, in arrears, based on what happened in that calendar month. So a patient who discharges on the 20th still has 19 days of monitoring to bill for.

Wait until the calendar month containing the discharge date has closed (or use Bill now if you want to close out early).

Open Billing -> Claims and filter by the patient. You'll see line items for every CPT code they earned that month:

99454 if they hit the 16-day device threshold
99457 if your team logged at least 20 minutes of management time
99458 for each additional 20 minutes (up to two add-on units, per CMS rules)
99470 as an alternative if you logged 10–19 minutes (CY 2026 add)

Click Review and confirm the diagnosis attached to each line is correct.

Have a provider Sign the claim batch. Export to your clearinghouse or billing partner.

4. Preserve the audit trail

Discharged patients are not archived automatically. They stay visible (but read-only) in Patients -> Discharged so you can:

Pull a discharge summary if a downstream provider asks
Show an auditor every reading, alert, time entry, and threshold change for the duration of the episode
Reactivate the patient if they ever come back to RPM (their old threshold profile is preserved)

When you're confident no further action is needed and the regulatory retention clock is ticking, archive the patient using the steps in Managing patients -> Archiving. The record stays encrypted and accessible to compliance staff for the full HIPAA six-year window before any expungement is even considered.

Offboarding checklist

A quick sanity check before you call a patient fully offboarded:

Discharge reason and date recorded
Device unassigned and physically retrieved (or written off)
Final month's claims reviewed, signed, and exported
Discharge summary printed and filed in the patient's EHR if your workflow requires it
Patient's status now shows Discharged on the dashboard

If all five are true, you're done. The patient's record stays put: quiet, encrypted, and audit-ready.