Tag Archives: chronic care

Chronic Care Management Services In Federally Qualified Health Centers

What are FQHCs?

Federally Qualified Health Centers (FQHCs) in the United States are non-profit entities comprising of clinical care providers, that operate at comprehensive federal standards. The care providers in FQHC are a part of the country’s health care safety net, which is defined as a group of health centers, hospitals, and providers who are willing to provide services to the nation’s needy crowd, thus ensuring that comprehensive care is available to all, regardless of income or insurance status. FQHC is a dominant model for providing integrated primary care and public health services to low-income and underserved population. There are two types of FQHCs, one receives federal funding under Section 330 of Public Health Service Act and the other meets all requirements applicable to federally funded health centers and is supported through state and local grants. To receive federal funding, FQHCs must meet the following requirements.

Be located in a federally designated medically underserved area (MUA) or serve medically underserved populations (MUP)
Provide comprehensive primary care
Adjust charges for health services on a sliding fee schedule according to patient income
Be governed by a community board of which a majority of members are patients at the FQHC

What is Chronic Care Management?

The CMS introduced the Chronic Care Management program in 2015. It insisted care coordinators give 20 minutes of monthly non-face-to-face care management services for beneficiaries with two or more chronic conditions. It helps in managing their conditions, risk factors, medication adherence, and coordination of care with other providers. In order to claim CCM reimbursements, the practices must offer

24/7 access to care management services
a platform for direct patient-practitioner communication
ability to manage transitions between providers and settings

Chronic Care Management in FQHCs

It is not mandatory for FQHCs to furnish Chronic Care Management services for their patients. These services can be given in addition to any routine care coordination services already furnished as a part of the patient’s visit to FQHC. Though it is not mandatory for them to give CCM services, they can bill for the same if the CCM requirements are met.

The CCM billing for FQHCs is a little different though. For CCM services furnished between January 1, 2016, and December 31, 2017, FQHC can bill the under the CPT code 99490. Payment is based on the Physician Fee Schedule (PFS) national average non-facility payment rate for CPT code 99490. FQHC claims submitted using CPT code 99490 for services on or after January 1, 2018, will be denied.

For CCM services furnished on or after January 1, 2018, FQHCs can bill CCM services under the general care management HCPCS code, G0511. CMS has set the payment annually at the average of three national non-facility PFS payment rate for CPT codes 99490, 99487 and 99484.

It is important to note that the 2018 payment of HCPCS code G0511 is $62.28. It is high compared to the reimbursement of $42, CMS gives to practices other than FQHCs under the 99490 CPT code.

Why should FQHCs give CCM services to their patients?

Increased reimbursements – FQHCs receive grants for treating their patients. When they provide Chronic Care Management services to their patients, they get more grants from CMS. This increases the revenue for FQHCs.
Improved patient satisfaction – Chronic Care Management services establish a long-term connection with patients. The patients can reach out to the physicians at any time in need. This improves patient experience and the FQHC will see more patients coming into their hospital.

HealthViewX Chronic Care Management Software, the best fit for FQHCs

FQHCs are reluctant in giving CCM services to their patients as it is a laborious task. With increasing CCM requirements from CMS, FQHCs are worried about taking up the Chronic Care Management program. This is when an electronic healthcare product can come to play. HealthViewX Chronic Care Management solution has features that solve most of the problems faced by FQHCs.

Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
Automated call log feature – After a patient call, care plan creation or any action related to Chronic Care Management services, call logs are added to the patient. It reduces the physician’s manual effort is logging the call logs.
Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the Medicare reimbursements.
HIPAA compliance – HealthViewX Chronic Care Management is HIPAA compliant. It facilitates secure data exchange. Our solution manages all patient-related documents securely.

HealthViewX Chronic Care Management solution is on par with the current requirements of the CCM program by the CMS. It helps FQHCs to set up a CCM program with the least investment. To know more about our Chronic Care Management solution, schedule a demo with us.

What Are The Requirements To Start Chronic Care Management Program For Your Practice?

Medicare Chronic Care Management program

More than 45% of the American population is suffering from at least one chronic condition. CMS had an insurance policy to reimburse the hospital expenses of chronic patients. Due to inefficient care, the patients were readmitted to the hospital. This, in turn, increased the Medicare reimbursements. Medicare identified the need for continued care to patients with chronic conditions. In order to cut down on insurance expenses and provide continuous care to patients, Medicare introduced the Chronic Care Management (CCM) program.

In 2015, Medicare introduced the Chronic Care Management (CCM) program. It is defined as non-face-to-face services provided to its beneficiaries. In addition to office visits and other face-to-face encounters (billed separately), these services include

Communication with the patient
Health professionals being available both electronically and by phone for care coordination, medication management, and being accessible to patients.

Medicare provides Chronic Care Management services for patients with multiple (two or more) chronic conditions

Expected to last at least 12 months or until the death of the patient.
Places the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline.

CCM Service Summary

The following are steps through which a Chronic Care Management service is furnished,

Initiating Visit – Initiation during an Annual Wellness Visit (AWV), Initial Preventive Physical Examination (IPPE) or face-to-face E/M visit for new patients or patients not seen within one year prior to the commencement of Chronic Care Management services.
Structured Recording of Patient Information Using Certified EHR Technology – Structured recording of demographics, problems, medications, and medication allergies using certified EHR technology.
24/7 Access & Continuity of Care – Provide 24/7 access to physicians or other qualified healthcare professionals or clinical staff and continuity of care with a designated member of the care team.
Comprehensive Care Plan – Creation, revision, and/or monitoring of an electronic person-centered care plan.
Enhanced Communication Opportunities – Enhanced opportunities for the patient to communicate with the physician through not only telephone access, but also the use of secure messaging, Internet, or other non-face-to-face consultation methods.

Why Chronic Care Management?

Most practices have a large population of patients with two or more chronic conditions. In fact, 68% of Medicare patients fit this description. The goal of a practice is to help their patients get healthier and improve their overall standard of living. This can be tough in case of chronic patients who require significant additional support. The practice may not have the resources to provide care. Without the proper systems in place, treating patients with chronic conditions is difficult to manage. That’s when the Chronic Care Management (CCM) program comes to play.

CPT codes for CCM

99490	$42	CCM services for at least 20 minutes of clinical staff time directed by a physician or other qualified healthcare professional per calendar month
99487	$60	CCM services for at least 60 minutes of clinical staff time directed by a physician or other qualified healthcare professional per calendar month
99489	$47	Each additional 30 minutes of clinical staff time directed by a physician or qualified healthcare professional per calendar month.

Chronic Care Program Requirements

One of the biggest obstacles that prevent medical practices from engaging in these programs are the inherent requirements for Medicare reimbursement. Some of these requirements include:

An established care team
A thorough care plan
24/7 access to clinical staff
Coordination with clinical providers
20+ monthly minutes of non-face-to-face care coordination

Partnering with CCM

With the available finite resources, the practice can partner with CCM services. Chronic Care Management services have the following advantages,

Good Medicare reimbursements depending on the service given
Ability to provide care and support to the patients for managing their conditions better
No additional cost if billing is managed within the network.

HealthViewX Chronic Care Management solution features

As the requirements of Chronic Care Management program are more, practices face difficulty in meeting the requirements. HealthViewX Chronic Care Management solution supports the following features that simplify the process,

Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
Automated call log feature – After a patient call, care plan creation or any action related to Chronic Care Management services, call logs are added to the patient. It reduces the physician’s manual effort is logging the call logs.
Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the Medicare reimbursements.
HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. All patient-related documents are managed securely.

HealthViewX Chronic Care Management solution is on par with the current requirements. It helps the practice to set up a CCM program with the least investment. To know more about our Chronic Care Management solution, schedule a demo with us.

References

www.fightchronicdisease.org/sites/default/files/docs/Almanac_FINAL.ppt

Physicians Complete Guide to Chronic Care Management

Senior citizens with one or more chronic conditions have a hard time managing their health. CMS was spending a lot of money on patient’s insurance who were suffering from chronic conditions. In order to cut down the expenses on hospital admissions, the CMS introduced the Chronic Care Management program. Patients usually visit their physicians for chronic care once or twice a year. With a Chronic Care Management program, a patient’s health improves due to increased attention and care. They can also spend less time on health issues and more on what they like to do.

What is Chronic Care Management?

Medicare defines Chronic Care Management program as non-face-to-face service provided to its beneficiaries with multiple (two or more) significant chronic conditions. In addition to office visits and other face-to-face encounters (billed separately), these services include

Communication with the patient
Health professionals being available both electronically and by phone for care coordination, medication management, and being accessible to patients.

Time-consuming process

Despite the increased Medicare reimbursement rates, patients do not get CCM services due to the physician’s time constraints. Chronic Care Management program requires a lot of time and effort from the physician. Unfortunately, providers must meet a number of requirements to qualify for a CCM Medicare reimbursement. These include:

Twenty minutes of non-face-to-face conversation per month with the patient
Use of a certified EHR
Create a patient care plan based on the assessments and available resources
Provide the patient with a copy of the monthly updated care plan and document the same in the EHR
Ensure that the care plan is available electronically to anyone within the practice providing CCM services
Share the care plan electronically outside the practice as appropriate
Ensure 24/7 access to care management services
Ensure continuity of care with a designated practitioner or member of the care team who will take care of successive routine appointments

The list goes on at considerable length defining the care practice must give. The fact sheet offered by the CMS goes up to eleven pages with multiple requirements to bill for CPT code 99490. This can become quite cumbersome for any practice, considering that the Medicare reimbursements are only $42.60/patient/month.

Steps to improve the Chronic Care Management program

1.Building a strong team

If a practice chooses to offer CCM services, it will be an investment. The demands include

Additional staffing with additional salaries,
Benefits and increased workload for management.
Additional office space depending on your current facility
It is important for the practice to set up a plan of action to calculate the required additional staff members required and the exact cost of this service. The practice must,
Start by assessing how many patients in the practice will be eligible to receive CCM services.
Identify how many people are needed to give quality CCM services to their patients and also additional salaries and benefits, added office space, etc.
It is important to analyze the merits and demerits from a financial perspective. Even if a practice is not profiting from CCM in the first stages, it is always possible to derive profit later.

2.Outsourcing Chronic Care Management services

Many private practices and hospitals who want to offer CCM services but cannot the implementation process can opt for outsourcing their CCM. There are vendors who provide this service and understand the new requirements better for reimbursement eligibility. In essence, they become an extension of the practice and require minimal financial investment from the provider. By this, the practice can manage the risk factors, patient experience, and profit better. A study on outsourcing chronic care management for diabetes patients found that those who participated in the outsourced care,

Rated the experience more positively
Demonstrated better clinical outcomes than those who received clinic-based care

3.Using a Chronic Care Management software

Chronic Care Management software can reduce the time and the manual effort spent in giving the CCM services. HealthViewX Chronic Care Management solution has the following features that make the process simpler,

Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
Automated call log feature – After a call, care plan creation or any action related to CCM health services, the system automatically adds call logs. It reduces the physician’s manual effort is logging the call logs.
Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the Medicare reimbursements.
HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. The solution manages all patient-related documents securely.

A healthcare practice following the above steps will find significant improvement in their Chronic Care Management program. HealthViewX Chronic Care Management software has features that suit practices as well as CCM vendors. To know more about our Chronic Care Management solution, schedule a demo with us.

References

Wolf, M. S., Seligman, H., Davis, T. C., Fleming, D. A., Curtis, L. M., Pandit, A. U., … & DeWalt, D. A. (2014). Clinic-Based Versus Outsourced Implementation of a Diabetes Health Literacy Intervention. Journal of general internal medicine, 29(1), 59-67.

Outsourcing Chronic Care Management In 2019 – Associated Benefits And Risks

Medicare has offered reimbursements to physicians for Chronic Care Management services since 2015. But still, providers are struggling with patient engagement, education, efficient processes and regulatory compliance.

CCM provider provides 20 minutes of monthly non-face-to-face care management services for beneficiaries with two or more chronic conditions. It helps in managing their conditions, risk factors, medication adherence, and coordination of care with other providers. To bill for CCM services, practices must offer

24/7 access to care management services
a platform for direct patient-practitioner communication
ability to manage transitions between providers and settings

Why are hospitals outsourcing CCM services?

CCM program is a labor-intensive process. It requires

Recruitment and training certified staff
EHR systems to track care plans
Monitor and document monthly calls
Making staff available to patients 24/7
More office space

In order to avoid these challenges, hospitals are outsourcing CCM services.

Advantages of outsourcing CCM services

New significant revenue stream – A small hospital cannot afford costly EHRs, handle staff-patient management, etc. These aspects are important for chronic care management implementation. Hence they are outsourcing CCM services. The outsourcing agencies specialize in CCM services and take a part of the profit from the practice. It generates a new significant revenue stream for practices who otherwise cannot get Medicare CCM reimbursements.
Saves physician’s time and effort – Outsourcing CCM services overcome the time-intensive CCM challenge for many physicians. Many of them do not have the professional staff bandwidth to provide the continuous chronic care management services. The new CMS initiative of paying doctors for CCM services works well with outsourcing.
Better patient satisfaction– The billing physician creates a specific healthcare plan for his patients. The physician then turns that plan over to the CCM vendor who is responsible for the daily or weekly contact with the patient. The CCM vendor monitors the patient’s progress and provides health coaching according to the physician’s care plan. The vendors must make sure that the patient is adhering to the plan and keep the physician posted. This allows the physician to extend his chronic care management to more patients with the required staff bandwidth.
Improved patient interaction – Outsourced services can combine technology, clinical services, and analytics with minimal efforts from the physician’s end. It results in improved patient interactions between actual office visits, with no impact on their current professional staff.
Increased patient enrollment – Outsourcing CCM will allow the physician to

increase and maximize patient enrollment in the program
improve patient compliance
provide CCM documentation requirements

while minimizing the physician’s workload.

Risks of outsourcing CCM services

1. Risk Management – Outsourcing CCM may sound easy on the front end, but it is very hard to mitigate the risks on the back end. Medicare fraud violations cost up to $10,000 per incident and may even subject the physician to a jail term. Outsourced CCM services make the practice actively and directly responsible for multiple risk factors:

Is the person performing the work appropriately credentialed to work in the state (especially nursing-staffed call centers)? Has the practice taken active steps to confirm this is?
Are all of the services billed for on the claims actually performed? Is the practice actively performing spot checks to ensure same?
Is the practice periodically checking that the documentation they receive for these claims and services is actually legitimate?
Is patient’ privacy taken care of? It is HIPAA-compliant?
Is the practice provided audit logs to protect them if they are audited? How often do they receive audit logs?

Never forget that an outsourced CCM vendor is paid on the volume while you hold 100% of the risk. At a minimum, this creates misaligned incentives and requires the practice’s perpetual and diligent oversight.

2. Profit factor – CCM vendors may take from half up to two-thirds of the CCM reimbursement for complete outsourced CCM service. When the added expenses are taken out of the payment, a practice may get only $7 to $12 per patient. In addition to paying the third party, it also has the labor cost of

Filing the claim
Paying the clearinghouse and the biller
Collecting $8 copay.
At one point, there is no profit from outsourced services

3. Patient’s experience – When a practice outsources the CCM services, the CCM vendor takes care of following up with the patients. Every time a patient gets a call, the person calling for rendering CCM service is unknown to them. The patients are not happy with different people calling them up every month. The vendors will not be fully aware of the patient’s medical history resulting in an average CCM call. The patient will also not feel good about talking to random people every month. Patients become dissatisfied with the outsources CCM services and leave the network.

4. Losing continuity with patients – In outsourced CCM, the practice does not get in touch with their patients regularly. When the patient visits the hospital, the physician will have to go through the previous CCM service history. It is better for the practice to do CCM services rather than give it to a CCM vendor. It affects the practice’s patient network and results in revenue loss.

Outsourced CCM services have a mix of advantages and risks. HealthViewX Chronic Care Management solution supports outsourced CCM as well as CCM services provided directly by the practice. The risk factor associated with outsourcing CCM is minimal in HealthViewX Chronic Care Management software.

HealthViewX Chronic Care Management solution features

HealthViewX Chronic Care Management solution has the following features that make the process simpler,

Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
Automated call log feature – After a call, care plan creation or any action related to CCM health services, the system automatically adds call logs. It reduces the physician’s manual effort is logging the call logs.
Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the reimbursements.
HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. The solution manages all patient-related documents securely.

HealthViewX Chronic Care Management solution has features that suit practices as well as CCM vendors. To know more about our Chronic Care Management solution, schedule a demo with us.

References

http://www.federalcharges.com/medicare-fraud-charges-penalties/

What is Complex Chronic Care Management – All you need to know

Chronic Care Management

The Centers for Medicare & Medicaid Services (CMS) considers Chronic Care Management (CCM) as a crucial part of primary care. Chronic Care Management is non-face-to-face care provided to Medicare patients with two or more chronic conditions. It contributes to better health services to people. In 2015, Medicare started to reimburse a certain amount for the Chronic Care Management services under the Medicare Physician Fee Schedule (PFS).

Service Codes

CPT 99487 – Complex chronic care management services with the following required elements:
- Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
- Chronic conditions place the patient at significant risk of death, acute exacerbation, or functional decline
- Establishment or substantial revision of a comprehensive care plan
- Moderate or high complexity medical decision-making
- 60 minutes of clinical staff time directed by a physician or other qualified care provider, per calendar month
CPT 99489 – Each additional 30 minutes of clinical staff time directed by a physician or other qualified care provider, per calendar month (List separately in addition to code for primary procedure)

Difference Between CCM and Complex CCM

CCM (“non-complex” CCM) and complex CCM services have similar health service elements. They differ in the following aspects,

Amount of clinical staff service time provided
Involvement and work of the billing practitioner
The extent of care planning performed

According to Medicare, “Complex Chronic Care Management services of less than 60 minutes in duration, in a calendar month, are not reported separately. Practitioners must report CPT 99489 in conjunction with CPT 99487. They must not report CPT 99489 for care management services of less than 30 minutes along with the first 60 minutes of Complex Chronic Care Management services during a calendar month.”

Eligibility Criteria for Care Providers

Physicians and the following non-physician practitioners may bill CCM services:

Certified Nurse Midwives
Clinical Nurse Specialists
Nurse Practitioners
Physician Assistants

Patient Eligibility

Medicare provides Chronic Care Management services for patients with multiple (two or more) chronic conditions

Expected to last at least 12 months or until the death of the patient
Places the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline

As Chronic Care Management services have reimbursements, physicians must consider administering CCM to the eligible Medicare patients. The billing practitioner cannot report both complex and regular (non-complex) CCM for a given patient for a given calendar month. In other words, a given patient receives either complex or non-complex Chronic Care Management services during a given service period, not both.

Supervision

The Complex CCM codes (CPT 99487, 99489) come under the general supervision according to Medicare PFS. A billing practitioner need not give the health service personally. Any qualified care provider can give the service under the billing practitioner’s overall direction and control. The billing practitioner’s physical presence is not required.

CCM Service Summary

Care providers give a non-complex or complex Chronic Care Management service through the following steps,

Initiating Visit – Medicare requires initiation of CCM services for new patients or patients not seen within one year of commencement of CCM. It is a face-to-face visit with the billing practitioner. It includes an Annual Wellness Visit [AWV] or Initial Preventive Physical Exam [IPPE], or other face-to-face visits. This initiating visit is not part of the CCM service and is separately billed.
Structured Recording of Patient Information Using Certified EHR Technology – Structured recording of patient’s demographics, problems, medications, and medication allergies using certified Electronic Health Record (EHR) technology.
Comprehensive Care Plan – A person-centered, electronic care plan based on a physical, mental, cognitive, psychosocial, functional, and environmental (re)assessment. The care provider must,

Provide the patient and/or caregiver with a copy of the care plan
Ensure the electronic care plan is available and shared timely within and outside the billing practice to people involved in the patient’s care

24/7 Access & Continuity of Care – Provide 24/7 access to physicians or other qualified care providers or clinical staff and continuity of care with a designated member of the care team.
Enhanced Communication Opportunities – Enhanced opportunities for the patient to communicate with the physician through not only telephone access, but also the use of secure messaging, Internet, or other non-face-to-face consultation methods.

HealthViewX Chronic Care Management solution features

HealthViewX Chronic Care Management solution has the following features that make the process simpler,

Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
Automated call log feature – After a call, care plan creation or any action related to CCM health services, the system automatically adds call logs. It reduces the physician’s manual effort is logging the call logs.
Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture of the revenue perspective.
Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the reimbursements.
HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. The solution manages all patient-related documents securely.

HealthViewX Chronic Care Management solution has features that satisfy non-complex and complex CCM services. Medicare reimbursements for Chronic Care Management services increase the profits for community health centers. It also benefits patients with multiple chronic health conditions. To know more about our Chronic Care Management solution, schedule a demo with us.

Remote Care And How Chronic Care Management Simplifies It

Healthcare industry of the US has introduced many technologies to give the best care to all irrespective of their place, accessibility, etc. Remote Care to patients is the latest healthcare technology. It enables monitoring of patients’ health outside conventional clinical settings. This may increase access to care and cut down the healthcare delivery costs. Hospitals offer Telehealth services as a part of Remote Care. This includes,

Virtual Consultation – It is a virtual visit that takes place between the patient and the physician. It takes place through audio or video calls. It is effective for common problems like flu, acne, fever, etc. It reduces the patient’s traveling cost and provides better access to quality care.
Remote Health Monitoring – Patient Health Monitoring is the latest technology in the healthcare industry. Patient physiological data like blood pressure, blood sugar, heart rate, etc can be measured by external devices. It can be a Fitbit, apple watch, etc that can communicate with the system in the hospital. It will help the physician to always keep an eye on their patients’ vitals and prescribe telemedicine and preventive care plans.
Chronic Care Management – Chronic Care Management is non-face-to-face care provided to patients with multiple chronic conditions. Medicare reimburses a certain amount for the Chronic Care Management services given by the hospital. Chronic Care Management is most administered through audio calls.

As Chronic Care Management services have reimbursements, physicians must consider administering CCM to the eligible patients. Medicare provides Chronic Care Management services for patients with multiple (two or more) chronic conditions

Expected to last at least 12 months or until the death of the patient.
Places the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline.

CCM Service Summary

The following are steps through which a Chronic Care Management service is furnished,

Initiating Visit – Initiation during an Annual Wellness Visit (AWV), Initial Preventive Physical Examination (IPPE) or face-to-face E/M visit for new patients or patients not seen within one year prior to the commencement of Chronic Care Management services.
Structured Recording of Patient Information Using Certified EHR Technology – Structured recording of demographics, problems, medications, and medication allergies using certified EHR technology.
24/7 Access & Continuity of Care – Provide 24/7 access to physicians or other qualified healthcare professionals or clinical staff and continuity of care with a designated member of the care team.
Comprehensive Care Plan – Creation, revision, and/or monitoring of an electronic person-centered care plan.
Enhanced Communication Opportunities – Enhanced opportunities for the patient to communicate with the physician through not only telephone access, but also the use of secure messaging, Internet, or other non-face-to-face consultation methods.

Eligibility Criteria for Physicians

Physicians and the following non-physician practitioners may bill CCM services:

Certified Nurse Midwives
Clinical Nurse Specialists
Nurse Practitioners
Physician Assistants

HealthViewX Chronic Care Management solution features

HealthViewX Chronic Care Management solution has the following features that make the process simpler,

Inbuilt audio, video calling and messaging features – HealthViewX Chronic Care Management solution has inbuilt video and audio calling features. It helps in giving Chronic Care Management services to their patients. Secure messaging is also available through which the physicians and the patients can communicate.
Automated call log feature – After a patient call, care plan creation or any action related to Chronic Care Management services, call logs are added to the patient. It reduces the physician’s manual effort is logging the call logs.
Preventive Care plans – HealthViewX solution supports care plans for the Chronic Care Management service for a patient. The physician can create a care plan depending on the patient’s health report. It helps in monitoring the patient’s vitals.
Chronic Care Management Analytics – Dashboards with intuitive charts and tables give complete analytics of the Chronic Care Management services. It provides a clear picture from the revenue perspective.
Consolidated Report – The physician can generate a consolidated report of the Chronic Care Management services given for a particular period. This makes it easy for the billing practitioner for getting the reimbursements.
HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. All patient-related documents are managed securely.

HealthViewX Chronic Care Management solution is on par with the current requirements. Remote care is the easiest and the cheapest way to treat your patients. Medicare provides reimbursements for Chronic Care Management which makes it the best way to give care to patients from the remote. To know more about our Chronic Care Management solution, schedule a demo with us.