Tag Archives: emr

Why do Federally Qualified Health Centers need a Referral Management Software In Addition To An EMR?

Patient Referral Management is crucial for Federally Qualified Health Centers (FQHCs). With the advent of the Patient Protection and Affordable Healthcare Act, Electronic Health Records have been widely adopted across many FQHCs. There are many benefits to EHRs like improved,

  • Accessibility to patient data
  • Charge capture
  • Preventative health

Let us look into each of them in detail to understand an EMR/EHR implementation better.

Pros of EHR/EMR

1. Improved data accessibility

Before EHRs, access to medical charts required a fair amount of physical labor. For example, every time a patient visits the physician’s clinic or hospital, physician physically pulls their file from a storage space. As a result of this back and forth exchange, there was a greater chance of human error and charts would sometimes be missing information or be chronologically out-of-order.

EHRs, on the other hand, have eliminated the physical transporting, sifting and filing charts, making data available at all times. Additionally, for systems that allow remote access to charts, clinicians can even be offsite and still securely access patient files.

2. Computerized physician order entry

CPOE allows physicians to place lab and imaging orders, prescriptions and other notes electronically. This reduces the error of handwritten orders and allows the patient’s other physicians within the same network access to the order.

3.Preventative health

EHRs allow prompts for preventative health screenings. During routine doctor or urgent care visits, the physician has access to preventive health records conveniently in one place. If the patient is due for a cancer screening (such as mammogram or colonoscopy), or blood pressure testing, the referral coordinator can easily look this up via the EHR system and schedule an appointment for the patient.

4. Ease sign off for PAs and NPs

While this varies from state-to-state by law, physician assistants and nurse practitioners are typically required to have their notes approved and signed off on by their supervising physician. EHRs allow the revision and cosigning of notes to happen electronically as opposed to physically moving and signing the paper.

5. e-messaging between providers

As any referral coordinator can attest referral information, telephone tag between providers can be common and is a big time-waster. With EHR software, physicians can e-message across practices. One situation that benefits in particular from e-messaging is referrals. Rather than playing telephone tag to get an appointment scheduled, the physician electronically sends a message to schedule the appointment.

How can a Patient Referral Management Referral Management work in cohesion with an EMR/EHR system?

FQHCs prefer working with EMR/EHR systems because they are comfortable with it. So they do not wish to move out their EHR/EMR system. 

How great it would be if a Patient Referral Management software could integrate seamlessly with an EMR/EHR system? It can help in ensuring end-to-end Patient Referral Management without disturbing the existing system.

An EHR/EMR system has many advantages but when it is complemented with a Referral Management software practices can experience many more benefits.

HealthViewX Patient Referral Management solution provides easy steps to integrate with a practice’s EMR/EHR system. The patient demographics, diagnostic reports, test results or any sensitive information can be transferred safely. The solution is HIPAA-compliant with complete data security. It has the following features,

  1. Outbound Referrals – HealthViewX Referral Management Solution can integrate with both the receiving and referring end. For inbound referrals, it helps in channelizing various sources into one single queue. In case of outbound referrals, it facilitates integration with the existing system to read the patient data and send out referrals.
  2. Referral Timeline – In HealthViewX Referral Management System, any referral has a timeline, to capture and notify the progress of the referral to all the stakeholders. A referral will be mapped to a status which helps in tracking it better. For e.g. – If a patient does not show up for the appointment, the status of the referral can be changed to no-show and an appropriate reason can also be given. With the help of a referral timeline, the providers can always be aware of what is going on with the referral.
  3. Workflow and Task Management – A workflow can be defined on how the referral flow must be(business rules). Providers can create tasks to manage referrals by assigning it to the respective person.
  4. Improved communication – HealthViewX Referral Management Solution supports messaging and calling features for the referring and the receiving providers to stay connected.
  5. Data Management – The solution is HIPAA compliant and enables secure data exchange of all patient-related documents.
  6. Seamless Integration – The solution can seamlessly integrate with any EMR/EHR/RIS or Third Party application thus providing minimal disruption in the existing referral flow.
  7. Referral History Consolidation – The consolidated data regarding the referrals and the referral history of any patient can be printed as a hard copy at any time in pdf/excel.
  8. Smart Search – HealthViewX Referral Management solution has a smart search facility that helps in finding the right provider for the treatment required.
  9. Referral Data Analytics – Referral data-centric dashboard gives complete data regarding the number of referrals flowing out, the number of referrals in various status, patient follow-ups, etc.

HealthViewX Referral Management solution helps in building a secure referral network in no time. Our expert team will guide you in changing to a Patient Referral Management Software with minimal effort. Schedule a demo with us to know more about our solution.

 

 

Reference

University of California—Davis. “UC Davis study finds e-medical records have varying effects on productivity.” Dec. 2010. http://www.news.ucdavis.edu/search/news_detail.lasso?id=966

How Can The Healthcare Industry Equip Their Senior Patients For Chronic Care Management?

Healthcare organizations and chronic illness

By 2029, estimates show that senior patients will make up 20% of the population and a considerable share of healthcare spending. As it stands now, senior patients and patients with chronic illness make up to 5% of the population but nearly 50% of healthcare spending. How can healthcare organizations cap these rising costs.

According to a report from BDO Center for Healthcare Excellence & Innovation, healthcare organizations are taking more responsibility when it comes to older adult care and chronic care management,

From NEJM Catalyst survey, it was found that healthcare organizations are looking into

  • Home health services
  • Strong chronic disease plans
  • Health IT

to address the needs of a growing aging population.

How can healthcare organizations achieve patient-centric and value-based care?

As mentioned earlier, healthcare organizations are looking into home health services and care plans to treat patients with chronic diseases.

Home healthcare services – Home healthcare is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility. Examples of home health services include:

  • Wound care for pressure sores or a surgical wound
  • Patient and caregiver education
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status

In general, the goal of home health care is to treat an illness or injury. Home health care helps you:

  • Get better
  • Regain your independence
  • Become as self-sufficient as possible
  • Maintain your current condition or level of function
  • Slow decline

Strong chronic disease plans – Patients with one or more chronic diseases need doctor’s attention almost every day. The physicians create care plans for such patients with vitals, measurements, activities, pain, etc that need to be monitored. This will help in keeping chronic patients healthy if they follow the care plan strictly.

HealthViewX Care Management and Chronic Care Management solution to ease the process for healthcare organizations

Information technology helps in making the process simpler for healthcare organizations by reducing their time and effort. HealthViewx software provides Care Management and Chronic Care Management solutions which help in providing home health services and also care plans for chronic patients.

HealthViewX Care Management solution supports the following features,

  • Care plans to enable remote care – A provider can create a care plan for a patient depending on the vitals, treatments, measurements, etc that need to be tracked. The patient-centric application helps in logging data for the vitals specified in the care plan. If needed the care plan can also be printed.
  • Customizable dashboards to suit the need – Dashboards comprising of graphs and tables show a comprehensive data of the number of patients in different care plans depending on the patient diagnosis.
  • Scheduler to keep track of the appointments – An inbuilt scheduler keeps track of the appointments and sends timely reminders to both the patient and the provider. The chances of missing out an appointment are very less.
  • Audio and video calling features – HealthViewX Care Management solution support inbuilt audio and video calling features which help in connecting with the patients for follow-ups.
  • Patient-reported data – Patients can record data for all attributes in the care plan. Summary graphs and table data helps the providers in monitoring the patient vitals. The patient records can be anytime printed in pdf or excel report form.
  • Health device integration – HealthViewX Care Management solution can integrate with any wearable device like Fitbit, apple watch, etc. Hence the patients need not waste time in logging data in the application if they are already using wearables.

HealthViewX Chronic Care Management solution supports the following features,

  • 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.

HealthViewX Care Management and Chronic Care Management solutions have features that suit healthcare organizations best. To know more about our solutions, schedule a demo with us.

 

Reference

https://www.bdo.com/getattachment/4d33f6c8-6d21-41b1-bbc6-aac62f4a70fd/attachment.aspx?HC_Eldercare-Study_brochure_2018_WEB-(1).pdf=&utm_source=Media&utm_campaign=Candid%20Conversations%20on%20Elder%20Care

Does A Referral Management Software Really Enhance The Patient Experience?

          When patients need advanced treatment or additional diagnosis that cannot be given within the practice, they are referred to a specialist/imaging center. The process of managing all the patient referrals that are received or sent is called patient referral management. There are many challenges faced by the patients in the referral process.

Challenges faced by patients

Let us review a typical referral process including the challenges faced by the patients.

  1. Patient visits the PCP – Andrews met with an accident recently. He met his PCP, Dr. John the next day as he was experiencing pain in his knee joints. After examining him, Dr.John wanted him to consult an orthopedic. The doctor then initiated the referral.
  2. PCP initiates the referral – John created a referral in his EMR. He did not have time to do the insurance pre-authorization so he left it to Andrews. He then found an orthopedic and gave him referral information verbally. Now when he met the specialist, Andrews had to again elaborate his condition and problems to him. This increased the efforts he took to meet a specialist. It did no go well with Andrews as he was already in pain.
  3. Patient Disorientation – John had instructed Andrews about the specialist he should visit, tests he should take and how to explain his condition. Andrews found these instructions too complicated to comprehend. He left the clinic with lots of confusions and doubts.
  4. Patient visits the specialist – Andrews then called the specialist a number of times. The first two times, the line was engaged. Finally, when he got through, all appointments were booked for the day.  to confirm his appointment. He had to wait for 24 hours in pain to meet the specialist. He spent another two hours in coordinating with the insurance company. At last, He met the orthopedic after long hours of waiting in pain. He got treated but was not happy with the waiting time and negative experience. He did not get back to the PCP to share referral updates and plans to visit some other PCP next time.

Challenges faced by the physicians

What factors stop Dr.John from giving the best patient experience to Andrews?

  1. Insurance Pre-authorization – John runs a practice where he treats many patients in a day. He has not adopted a referral management software. So he has to do the insurance pre-authorization for his patients. It is time-consuming and tedious.
  2. Finding the right specialist/imaging center – The clinic has no effective approach for finding the right specialist/imaging center. The chances of missing out on a good specialist/imaging center are high as it is done manually as they are not updated regularly.
  3. No referral updates – John is not up-to-date with the progress of the referrals which makes referral loop closure impossible.

The lack of a systematic referral workflow increased the manual effort and makes it tedious to follow-up with patients and receive referral updates.

HealthViewX Patient Referral Management System

Considering the challenges faced by the patients, an automated Healthcare Patient Referral Management System is the need of the hour. Electronic healthcare referral management system helps healthcare organizations in the seamless processing of the referral process.

Let us review the same instance with HealthViewX Referral Management solution in place,

  1. Patient visits the PCP – Andrews met with an accident recently. He met his PCP, Dr. John the next day as he was having pain in his leg. After examining him, Dr.John wanted him to consult an orthopedic. The doctor then initiated the referral.
  2. PCP initiates the referral – John created a referral in HealthViewX system. HealthViewX does the insurance pre-authorization automatically in the background. With the help of the “Intelligent Smart Search” feature, he found an orthopedic. After giving the necessary information, John created the referral. The specialist got notified of the referral and all referral information were easily accessible by him.
  3. Patient Disorientation – Andrews left the clinic with clear information about the specialist and appointment details. There was no need for him to call up the specialist for appointment as everything is automated. The patient will be notified about the appointment and tests to be taken.
  4. Patient visits the specialist – Andrews met the orthopedic soon after the appointment was fixed. He got the best treatment and was satisfied with the referral process.

If you were Dr.John, would you not want Andrews to have a better experience? By using referral management software, you can ensure that Andrews’ knee pain heals while he also develops a positive opinion about your practice. Using a referral management software, you as a PCP can retain patients like Andrews in your network.

HealthViewX Patient Referral Management Solution features

  • Insurance Pre-authorization – HealthViewX solution supports automated insurance pre-authorization that reduces the manual work of the referral coordinators.
  • Intelligent Provider Match – The solution supports an “Intelligent Provider Match” Feature that helps in finding the right specialist/imaging center easily.
  • Seamless communication – HealthViewX solution has an inbuilt audio calling and messaging application which is secure and enables faster communication
  • HIPAA compliant data security – The solution is HIPAA-compliant and offers secure data exchange. It supports almost all formats of files and keeps the patient documents safe.
  • Referral history – The timeline view provides the history and current status of the referral. A status helps in knowing the referral progress.
  • Referral loop closure – Referral updates are hard to miss that makes it easier to close the referral loops on time.

HealthViewX Patient Referral Management application solves most of the challenges faced by the patients and PCPs. This increases patient satisfaction and revenue. To know more about HealthViewX solution, schedule a demo with us. Our patient referral management experts will guide you through our HIPAA-compliant solution.

Why Is Documenting A Medical Referral Not Easy For A Federally Qualified Health Center?

How does referral works in a Federally Qualified Health Center?

Federally Qualified Health Centers (FQHCs)  are private, non-profit organizations that directly or indirectly (through contracts and cooperative agreements) provide primary health services and related services to residents of a defined geographic area that is medically underserved. Federally Qualified Health Centers are high referral outbound centers, who send out a number of referrals in a day. A Federally Qualified Health Center has many PCPs who attend to numerous patients with different health problems. The PCP initiates referrals when the patient needs an additional diagnosis from an imaging center or a specialist practice. The following are the steps through which a referral flows,

  1. Referral Initiation – The referring provider gives the details of the patient and diagnosis to the central referral coordinating team. A referral coordinator will study the demographics of the patient and the diagnosis required.
  2. Insurance Pre-authorization – If the patient has an insurance coverage, the referral coordinator will validate the same. This step helps in finding out which imaging center or specialist practice will cover the medical expenses.
  3. Finding the right provider – Depending on the treatment required, insurance coverage, patient’s convenience, the referral coordinator will narrow down the search and find the right receiving provider for the referral.
  4. Sending out the referral – After finding the right provider, patient information and the diagnosis details are shared while referring. The physicians can share the information via phone, fax, email, etc depending on the source that suits the receiving provider.

Medical referral history documentation in Federally Qualified Health Centers

Referral history gives details of what has happened with the referral till date. The referral history is equally important to both the referring and receiving providers. Unfortunately, the receiving provider maintains this history through paper-based forms or EHR and it is not easily accessible to the referring provider. Documenting a medical referral is quite a challenge for the provider who initiates the referral. So what factors make it so tedious and challenging?

  • Physicians get busy – After the referral is initiated, the referring provider gets busy with other appointments and forgets about the referral until the receiving provider gives updates. Not to forget the receiving provider is also a specialist or from an imaging center who will also be busy. The receiving provider or the patient fails to communicate with the referring provider regarding the progress of the referral which makes it difficult to document the referral.
  • Lack of effective modes of communication – There is no effective platform to share patient’s sensitive data or communicate with the referring or receiving provider. The physicians are not available over calls or messages which makes the situation worse. There is a need for a standard HIPAA compliant application that the referring and receiving providers can use to share information which helps in referral documentation.
  • Manual effort making the referral process tedious – The referral process has manual intervention at every stage. This frustrates the providers and the referral coordinating team. Giving timely updates to the referring provider regarding a referral is too much of effort for the receiving provider. Documenting the referral manually becomes a challenge.

Why document a medical referral?

  • Patient’s need – The patient may come to the clinic at any time looking for the medical history of the referral. At that point, the clinic should be able to give the patient the medical referral history. So documenting a referral becomes a necessary process.
  • Clinic’s records for future reference – It is important for a Federally Qualified Health Center to maintain a history of its patient’s demographics and referral records. If the patient comes back to the clinic with an illness, these records will help in understanding the patient better and giving the best treatment the patient needs.
  • Direct future referrals – A history of medical referral records will help the physician in figuring out who responds quickly and who does not. The next time the physician sends out a referral, he/she will choose the most responsive and the most suitable receiving provider for the referral.

Information Technology to aid Federally Qualified Health Centers

Information Technology is transforming healthcare to a great extent. Documenting a medical referral is easy for a healthcare based software application like HealthViewX. HealthViewX Patient Referral Management solution simplifies the referral process by the following steps,

  1. Referral Initiation – The patient demographics and diagnosis required are already in the application. The referral coordinator can create the referral through a simple three step form which includes insurance pre-authorization, finding the appropriate receiving provider with the help of  “smart search”, etc. The receiving provider is notified of the referral.
  2. Referral status and timeline view – With the status, a referral is tagged to, the referring provider can get to know in what stage the referral is. A timeline view shows a history of stages through which the referral has progressed.
  3. Referral and timeline view reports – The timeline view and the referral analytics data can be generated as a report in any form chosen.
  4. Referral closure and feedback – If the referral is completed, the status can be changed to closed. A feedback form is generated for the patient and the receiving provider. This can help the referring provider in making the referral process better next time.

HealthViewX Patient Referral Management solution smoothes out the referral process and reduces the burden of the referring and the receiving ends of Federally Qualified Health Centers. Do you want to know more about HealthViewX Patient Referral Management solution? Schedule a demo with us.

 

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

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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/

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,

  1. 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.
  2. 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.
  3. 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,

  1. 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.
  2. Structured Recording of Patient Information Using Certified EHR Technology –  Structured recording of demographics, problems, medications, and medication allergies using certified EHR technology.
  3. 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.
  4. Comprehensive Care Plan – Creation, revision, and/or monitoring of an electronic person-centered care plan.
  5. 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.