SOLUTION: Patient-Centric Care

Clinical Services Focused
on Patient Outcomes


Patients are the
Center of the Care Circle

Orb Health’s care delivery services are staffed with experienced, licensed, and certified medical practitioners who are continually trained to meet and exceed the needs of the patients. Our proprietary and collaborative infrastructure empowers our teams with the same patient information as the health system so they know the patient's history immediately. Our system uses predictive analytics to warn our care teams if there is a possible issue so so they can proactively help patients avoid crisis incidents and hospital visits.

Orb Health has three teams that work seamlessly on behalf of the health system: the enrollment team that compliantly enrolls CCM eligible patients, care delivery staff that effectively provides comprehensive and predictive gap care, and our compliance team that ensures all interactions and documentation meets all regulations. The result is a comprehensive approach to compliant telehealth without adding additional staff to your practice.

Proactive Patient Outreach

Orb Health’s enrollment team uses the power of the integrated infrastructure to automatically identify eligible patients for supported codes (Chronic Care Management, Behavioral Health, Transition Care Management, more).

Our team then performs a systematic patient outreach campaign as an extension of your health system utilizing multiple methods.

Once connected, we explain the program in its entirety and compliantly gain verbal patient consent for enrollment. The end result is a patient enrollment rate of over 60%.

Meaningful Care Delivery

Care is delivered by licensed and certified medical practitioners that handle all aspects of the patient’s needs between office visits.

Appointment scheduling, specialist discovery, Rx management and ordering, deciphering lab results, condition education, and much more including being there just as someone who listens to their concerns.

Our services are broken down into smaller pods that maintain an industry low patient-to-nurse ratio, enabling meaningful relationships that drives a more engaged and compliant patient.

Audit-Ready Compliance

Our compliance teams check every interaction note and document to ensure all guidelines and requirements are met before we sync the data back to the EMR.

This level of review ensures you are always ready for an audit and we stand with you in the event one occurs.

This review includes all coding inside of the Orb health interaction so your own compliance, coding, and billing systems are presented with properly formatted information so they can efficiently perform their roles.

Critical Services that Reduce Emergency Department Utilization and Improve Patient Outcomes

Personalized Care Plans

Create and curate advanced care plans based upon personal needs then track activities, log actions, and follow patient problems and exacerbations.

Monthly Check-Ins

Perform monthly check-ins requiring 20 minutes of non-face-to-face time and record patient interaction.

Appointment Scheduling

Schedule patient appointments with the entire care circle including providers, specialists, caregivers, and more, as well as send alerts and reminders.

Medication Management

Medication refill management and adherence tracking as well as personal clinical medication reviews, medication efficacy tracking, and more.

Specialist Coordination

Work with the practice to find the appropriate specialists, schedule the appointments, and coordinate their interactions for any patients specific needs.

Deciphered Lab Results

Lab results are synchronized between providers and deciphered into a patient readable format complete with gauges showing positive / negative context and education.

24/7 Communication

Orb Health's clinical care teams are available 24/7 to assist patients with issues or questions with full interaction detail that is always available in the EMR.

Personalized Condition Education

Personalized material from Mayo Clinic is presented to patient as well as specific nutrition and exercise guides which are specifically created for the patients needs.

Care Coordination Dashboards

Dashboards for care teams and program managers unlock collaboration and streamline inter-group workflow, increasing efficiency and improving care.

Efficacy Tracking

Patient needs are tracked to resolution, lab values and vitals are monitored to ensure care plans are effective and health goals are met so clinical staff can quantify success.

Remote Patient Monitoring

Patient health is remotely monitored using hundreds of connected device options or entered manually with any elevated or out-of-range values alerted to clinical staff.