Tag Archives: hipaa violations

How Can Hospitals Improve Their Patient Referral Management By Complying With Meaningful Use

What is meaningful use?

Meaningful use (MU) is a health information technology (HIT) term that defines minimum U.S. government standards for

Using electronic health records (EHR)
Exchanging patient clinical data between health care providers, between health care providers and insurers, and between healthcare providers and patients

It has a set of rules known as meaningful use measures or meaningful use criteria. It determines whether or not a healthcare provider receives federal funds from the Medicare EHR Incentive Program, the Medicaid EHR Incentive Program or both.

Almost 99% of the hospitals in the U.S. use EHR systems. It is a huge leap by EHRs compared to 31% of hospitals back in 2003. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment history of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. EHRs can:

Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results
Allow access to evidence-based tools that providers can use to make decisions about a patient’s care
Automate and streamline provider workflow

Impacts of EHR on Care

Electronic Health Records create a greater and more seamless flow of information within a digital healthcare infrastructure. It encompasses and leverages digital progress and transforms the care delivered. With EHRs, hospitals experience improved,

Patient Care and participation
Care Coordination
Diagnostics and Patient Outcomes
Practice Efficiencies and Cost Savings

Three stages of Meaningful Use (MU):

Meaningful use is divided into three stages.

Stage 1, which began in 2010, focused on promoting the adoption of EHRs.

Stage 2, finalized in late 2012, increases thresholds of criteria compliance and introduces more clinical decision support, care-coordination requirements and rudimentary patient engagement rules.

Stage 3, which the CMS is writing from late 2014 through early-to-mid 2016, will focus on robust health information exchange as well as other more fully formed meaningful use guidelines introduced in earlier stages.

What are the incentives and penalties for meaningful use?

Under the HITECH Act enacted under the 2009 Recovery Act, incentive payments are available to eligible professionals who successfully demonstrate meaningful use of certified EHR technology.

The Recovery Act specifies three main components of meaningful use: The use of a certified EHR technology

In a meaningful manner
For electronic exchange of health information to improve quality of healthcare
To submit clinical quality and other measures

According to Medicare and Medicaid EHR incentive programs, the practices receive incentives if they meet the meaningful use requirements. If they do not meet the meaningful use requirements, they will be penalized.

Medicare EHR Incentive Program

Medicare incentive payments are equal to 75% of a practice’s annual Medicare Part B allowed charges up to a maximum yearly amount.

After 2015, providers who were eligible for the Medicare Meaningful Use program but did not successfully demonstrate Meaningful Use were penalized. The penalty started at 1% of Medicare Part B reimbursements and increased each year to a maximum of 5%.

Medicaid EHR Incentive Program

In the case of Medicaid patients, a practice can earn up to $63,750 in incentive payments over the six years that they choose to participate in the program.

If you start in 2015, you can earn incentives through 2020. Practices can consult their state’s agency for information about a specific payment schedule.

Providers who are eligible for Meaningful Use under the Medicaid program are not subject to payment penalties unless the provider is also eligible under the Medicare program.

How can a Patient Referral Management Referral Management enhance an EHR system to achieve meaningful use?

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

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.

HealthViewX Patient Referral Management solution provides easy steps to integrate with a practice’s EMR/EHR system. It also enables easy and safe transferring of patient demographics, diagnostic reports, test results or any sensitive information. The solution is HIPAA-compliant with complete data security.

HealthViewX can enhance a practice’s EHR capability by making it achieve meaningful use. The practice’s scoring can also improve by using HealthViewX Patient Referral Management solution.

HealthViewX Patient Referral Management solution features

It has the following features,

Inbound and 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.
Referral Timeline – Any referral has a timeline, to capture the progress of the referral. It is common to the referring and receiving provider. 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.
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.
Improved communication – HealthViewX Referral Management Solution supports messaging and calling features for the referring and the receiving providers to stay connected.
Data Management – The solution is HIPAA compliant and enables secure data exchange of all patient-related documents.
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.
Referral Data 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.
Smart Search – HealthViewX Referral Management solution has a smart search facility that helps in finding the right provider for the treatment required.
Referral Data Analytics – Referral data-centric dashboard gives clear figures regarding the number of referrals flowing in and 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

https://www.healthcare-informatics.com/news-item/ehr/survey-nearly-all-us-hospitals-use-ehrs-cpoe-systems

Attract And Retain Patients Within Your Network In Seven Simple Steps

Did you know? More than 80% of the patients rely on online reviews to evaluate patients. 8 out of 10 Americans internet users have researched topics including diseases, treatments, health insurance, a particular doctor or hospital. They do not go to the specialist just because they were referred to. Indeed patients spend a lot of time researching about the hospital and other options. Hospitals try to seek the attention of the patients through advertisements. But in this world of growing technology, ads through radios and billboards have become old-fashioned. So the hospitals are quite lost with the following questions in mind,

How can we reach our ideal patients at the right time with the right message?
How can we keep them happy and loyal?
If potential patients are no longer reacting to traditional advertising and promotional methods then what are they responding to?

It is through Patient Value Journey.

The way a patient chooses their health care provider shows what consumers want from a product or service. Below is the 7-step Patient Value Journey that can help practices turn patients into appointments and advocates of their practice.

The Patient Value Journey

Millions of Americans are embracing technology. From online search to wearables, they are transforming the patient journey at record-breaking speed. Google receives 63,000 searches per second on any given day and health care is the third most searched topic.

Considering the present reality, how can a practice drive more patient appointments both online and offline? The best marketing strategies begin and end with how a patient finds a practice and the process that flow after their first appointment.

1) Attaining Patient Awareness

A potential patient first becomes aware of the practice and its doctor(s) during the Patient Awareness Stage. Perhaps they have a health problem or concern, are researching a health condition and potential treatment.

In this early phase of the patient journey, the patient has a problem. The practice must present their solution while showing them what differentiates them from other practices. Potential patients can become aware of a practice in the following ways:

Seeing an advertisement
Finding the practice on social media
Receiving a referral from another doctor, friend or family member
Viewing the practice website as a search result on Google
Meeting at a health fair or community event

All these avenues present significant opportunities for a practice to reach potential patients both online and offline.

2) Patient Engagement

After becoming aware of the practice, a potential patient will take action to learn more of their doctor(s). After grabbing their attention, the practice must trigger them to interact with you or their social circles. Downloading a digital asset (white paper, checklist or eBook) from your practice website

There are numerous ways patients can engage with the practice including:

Searching specifically by name for the practice on Google
Visiting physician review sites to check their overall score
Sharing, commenting or liking one of their social media posts
Clicking on an ad or post that drives back to their website
Asking peers (online or offline) about their experience with the practice
Visiting the practice website

Digital marketing, social media, and website strategies are critical for bringing the patients to the subscription phase. When new visitors arrive at the practice’s website, it must impress the users in a few minutes. The site must have an eye-catching design, have killer content, and be easy to navigate. In addition to being desktop-friendly, the website must also be mobile-friendly.

3) Patient Subscription

In stage 3, potential patients will opt in to view or receive additional content from the practice. Here, a prospective patient likes what they have seen so far, but isn’t ready to commit to an appointment just yet. They are, however, seriously considering that practice for their health care needs.

What patient actions can the practice expect in this phase of the journey?

Joining an email list for the practice’s newsletter
“Liking” the page(s) on social media to receive updates in their newsfeed
RSVPing to attend a talk or seminar
Signing up for a webinar discussing a particular pain point or treatment option

There are several tactics a practice can employ to optimize patient subscriptions.

Keep blogs updated and post relevant content that readers can share across their social networks
Respond (ideally in real-time) to comments on their social media pages
Add social sharing buttons to their blog posts, newsletters, and general emails
Encourage readers to share their posts on their social media networks

4) Conversion

In the Conversion phase, the potential patient is satisfied with their research and is now ready to become a patient of the practice with a scheduled office visit. Upon entering the conversion stage, a patient will:

Book an appointment and schedule an office visit via the website or by phone
Set up a time for an in-office consultation about services
Not cancel the appointment

To ensure a patient’s smooth flow from subscription to conversion, the practice must make the transition easy for them.

If a potential patient spends precious minutes on the website trying to figure out how to contact or book an appointment, they’ll just give up in frustration. The site must make it easy for patients to schedule a visit on every single page.

5) Achieving Diagnosis and Treatment

In the diagnosis and treatment phase of the patient journey, the medical team diagnoses and prescribes treatment to the patient. The patient receives immediate value in the form of a diagnosis or treatment plan following the appointment.

Depending on the condition, the patient is under observation or conservative treatment over multiple visits and monitoring.

6) Ascension

As part of their journey, patients may or may not be prescribed additional treatments. It depends on their condition and their response to initial treatment(s) in the diagnosis and treatment phase.

Some patients will receive continued treatment as needed. Some others may be referred to supplementary services in or outside of the practice. While others may require surgery and rehabilitation.

7) Advocacy

In the Advocacy stage, the patient has completed their treatment protocol and is satisfied with the outcome of their care. They are now in a position to advocate for the practice both online and offline.

Patients can share positive feedback with the world by:

Providing an online review or rating on the physician(s) review website(s)
Taking part in a video testimonial to share their brilliant outcomes and benefits with other potential patients
Become the subject of a case study

Patient advocates are one of the most valuable assets for a practice. Patient success stories create a connection, build trust, credibility, and interest to motivate potential patients to answer a call-to-action.

Making the Patient Value Journey Work For You

The patient-physician relationship is a symbiotic two-way relationship. The patients can provide transparent feedback which can positively impact the start of other patient journeys.

Mapping the medical practice’s goals with Patient Value Journey helps in understanding the audience’s mindset and behavior. It can hone the practice’s short-term, quarterly wins and activities that contribute to reaching their long-term goals.

Using technology to solve patient-related problems

If your practice is facing problems related to managing patient traffic, patient referrals, chronic care management, remote patient monitoring or anything at all, HealthViewX is always there to solve your operational issues and optimize the workflow. To know in detail about our solution, schedule a demo with us.

References

http://www.internetlivestats.com/google-search-statistics/

https://www.healthcareitnews.com/news/pew-study-health-information-third-most-popular-online-pursuit

http://www.nbcnews.com/id/3077086/t/more-people-search-health-online/#.W4zdVc4zbIW

https://www.softwareadvice.com/resources/how-patients-use-online-reviews/

How valuable is a Patient Referral Management Software To Primary Care Physicians?

When PCPs send a referral to a specialist, they expect that specialists will let them know when their patients received care. Many times it doesn’t happen as expected. The hospital may be too busy to share information. In other cases, the hospital may have faxed a notification to a patient’s primary care physician (PCP). But, for one reason or another like coordination issues, busy schedule, the physician practice may never have received it.

There are many such problems as the above PCPs deal with every day. Let us read through a few in detail.

Insurance pre-authorization – The time a PCP invests on the process of insurance pre-authorization is more. Waiting for the insurance to respond is neither good for the PCP, not the patient.
Finding the right specialist/imaging center – The number of imaging centers and specialist practices is increasing day-by-day. It takes a lot of time and effort for the referral coordinator to narrow down the referral coordinator’s search and find the right one.
Time Spent – As the referrals are handled manually, a referring coordinator spends about half-an-hour to one-hour for a creating referral on an average and even more time in following up the same.
No Updates – After a referral is sent, both the referring and the receiving providers get busy. It is not possible for both of them to be updated on the referral progress. So the specialist/imaging center and the patient fail to update the clinic on the progress of the referral. This results in open referral loops.

Manage your patient referrals better with the HealthViewX solution

Fortunately, many PCPs are realizing the need for a better way to process and manage referrals securely. This is when they feel an automated Patient Referral Management System can help.

HealthViewX Patient Referral Management solution enables creating a referral in three simple steps thus providing a successful referral program. After the referral is created, it can be tracked with help of the status. Both the referring and receiving providers will be notified of the appointments, test results, treatment recommendations, etc. HealthViewX can integrate with EMR/EHR and can also coordinate between the referring and the receiving sides. Any referral has a timeline view which is common to both the receiving and the referring providers. In the timeline view, history of the referral can be seen for eg: notes related to the patient’s health, previous status of the referral, etc. Documents attachment and status change can also be done at any time of the referral process. HealthViewX Patient Referral Management solution can always keep you updated on the progress of the referral thus simplifying the referral process and helps in closing the referral loop.

How has HealthViewX added value to PCPs’ patient referral problems?

1) Automating the insurance pre-authorization process

HealthViewX platform has a payer management module that maintains and manages

different payer details
their modes of prior authorization
direct authorization procedures
payer forms
online portal links

With this information already present, it provides the referral coordinator the capability to automate

prior authorization submission
status checks coupled
fax integration

It simplifies the process of insurance pre-authorization. The referral coordinator need not waste time on the process anymore.

2) Intelligent Provider Match

Our “Smart Search” feature makes it easy for the referring provider in finding the right provider. It has smart filters and search options that help in narrowing down the specialist based on the requirements.

3) Establishing best practices

After using our HealthViewX Patient Referral Management System, physicians were automatically alerted to

Appointments
Referral status
Patient diagnostic reports
Referral completion

As a result, we can cut down on miscommunications and bridge the gaps between the specialist and the physician community. The system also assembles a patient encounter record from the EMR/EHR and pushes it directly to the physician.

4) Forming a close-knit of trusted referral receiving centers

Our system helps in strengthening ties with the medical community. From a history referral experiences the PCPs can from a close-knit of referral receiving providers. Physicians can refer now patients to hospitals they can rely on.

HealthViewX Patient Referral Management solution helps the PCPs in handling and managing their referrals. Are you a PCP looking for an end-to-end referral management solution? Schedule a demo with us. Our patient referral management experts will guide you through our HIPAA compliant solution.

How Can A Hospital Tackle Their Operational Problems With The Help Of A Software?

Hospitals are crucial in giving care to patients who come to them with various problems. With increasing health problems, the number of patients visiting the hospital is also increasing. As per the survey by Statistics Portal, Community hospital expenses per inpatient stay in the U.S has been increasing. Are hospitals doing enough to manage the increasing number of patients? Many hospitals are still managing their process and workflows manually. So what challenges do they face in handling such huge patient data and process manually?

Challenges faced

Let us a scenario based example to understand the challenges better. James is suffering from a headache for the past two days. He thought it would get better if he takes rest but it only became worse. He realized that he was running a high temperature and decided to visit the doctor.

The patient is trying hard to fix an appointment with the doctor – James had heard about a famous doctor nearby. Nothing was mentioned online about their opening or closing hours or if they were working today or not. Luckily he found the contact details. James calls up the doctor. The line was engaged. It was a holiday so many patients were trying to reach the clinic. He tried for half an hour before his call got connected. By that time most of the appointments were booked for the doctor. James finally got a slot to meet the doctor at 4 pm. This did not go well with James as he was already suffering from a severe headache. He felt that the hospital must have some means of scheduling appointments without any hassle during busy days.
Patient waiting to visit the doctor – James reached the clinic at 3.30 pm. He thought that his visit would be fine as he had already booked an appointment. He was surprised by the crowd. He found that there were ten more patients before him waiting to visit the doctor. He was not happy with the clinic as he had to wait for one more hour to visit the doctor. Why should he wait even after having booked an appointment? He regrets choosing this clinic as his headache is getting worse. The clinic had nothing interesting like magazines or tv to while away the time. That one hour of waiting was really bad for James. After meeting the doctor, James felt better. He finally came out of the clinic at 5.30pm after getting his medications.
Patient engagement – The clinic does not collect patient feedback about their visit to their health. James was looking for something like a feedback to make the clinic aware of his concerns. It seemed like they were too busy to hear him out. He went out of clinic thinking to never return to this place.

It is obvious that James is going to tell some other friends and family about his bad experience in this clinic. The chances of patients visiting the clinic after listening to him are less.

The above were the challenges faced by patients. But what challenges prevent the clinic from meeting the patients’ expectations?

Appointment scheduling – The clinic has an outdated method of fixing appointments over phone calls. There are no systematic methods of collecting patient requests and processing it as appointments. There is an extent to which appointments can be managed manually. When the number exceeds and when managed manually, it leads to patient dissatisfaction and also affects the workflow of the clinic.
Patient no-show rates – Many patients do not show up for appointments. The reason can be anything. The patient might have forgotten, visited another doctor or might have got better. There is no way of tracking which patients did not show up and why. The patients do not get reminders of the appointments which is an important reason for the increasing no-show rates.
Remote patient monitoring – There is no chance for the patient to get in touch with the physician in case of an emergency. Physicians are usually busy and are not available to patients for support. Though they are busy, it is good to make them available to the patients. It might be a case of emergency and the doctor’s advice might be crucial in that case.

How can a Software help in solving the challenges in the healthcare industry?

With the above-mentioned challenges, it is not good for a practice to manage its workflow manually. This is when Information Technology can help. Many physicians are skeptical about the cost a software will incur. They are not aware that healthcare software can solve their challenges and thereby reduce manpower. HealthViewX solution has the best features that can easily solve the problems of any practice.

No change in the current process – The HealthViewX solution can be integrated with EMR/EHR and can write data of referral into any system if required. It is almost zero deviation from the current workflow a practice is using.
Appointment scheduling and management – The HealthViewX solution has an application for the patients. They can conveniently fix appointments with the doctor depending on the schedule. The application also gives timely reminders to the patient and the physician about the appointment. It reduces patient no-show rates, patient waiting time and patient leakage. It has a positive impact on the workflow and patient’s experience.
Electronic Care Plans – The solution enables care plan creation. It helps in monitoring patient’s vitals, measurements, etc. If required, it can also be printed and handed over to the patient. This feature is in order to keep the patients engaged and encourage them to stay healthy by adhering to the care plan.
Audio and Video Calling features – It has an inbuilt audio calling and messaging application which is secure and enables faster communication. In case of an emergency, the patients can easily contact the doctors.
Patient Reported Data – Patients can record data for all attributes in the care plan. Summary graphs and table data helps the provider in monitoring the patient’s vitals. The patient medical records can be anytime printed in pdf or excel report form.
Health Device Integration – HealthViewX 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.
Report Consolidation – The data regarding the patients’ health attributes can be printed as a report anytime in pdf/excel form.
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.

HealthViewX software solves most of the challenges faced by the practices. It increases the revenue and efficiency reduces manpower. Do you want the solutions HealthViewX offers in detail? Schedule a demo with us.

References

https://www.statista.com/statistics/459772/community-hospital-expenses-per-inpatient-stay-in-the-us/

How Can Physicians Benefit From HealthViewX Chronic Care Management Solution

More than half of the U.S population is suffering from various chronic conditions. Such patients need continued care and support from their physicians. Considering the physicians’ busy schedule, they cannot extend special support to every other patient with chronic conditions. This directly affects chronic patients. Both physicians and patients face a lot of challenges in the process of giving care to chronic patients.

Care Management Workflow for Chronic Patients

Let us consider a scenario to explain the care management workflow for chronic patients.

The chronic patient gets sick – Lily is a diabetic patient who also had blood pressure. She fell down and hurt her head so severely that she started bleeding. As she was diabetic, the wound did not heal. She wants to visit Dr. Matthews who is her PCP.
PCP examines the patient – Dr. Matthews is a busy physician who runs a clinic. Lily waits for two hours to get his appointment. The doctor examines Lily along long hours of her waiting. He advises her to stay in the hospital for two days. The nurses there take good care of her by giving her medications on time, attending to her whenever in need, etc.
The patient gets discharged – After two days, Lily feels that she is all right. She is discharged from the hospital. Dr.Matthews prescribes her medications to be followed strictly to get completely well.
Patient falls ill again – Though Lily takes care of herself, the wound starts bleeding again. She tries reaching the doctor but to no avail. It was only after a day did she get his appointment again.
The patient is readmitted – Dr. Matthews examines her again. He finds that she did not take the medications appropriately. He advises her to stay in the hospital for another day.

Challenges faced by physicians

Though Dr.Matthews took good care of Lily, it could not avoid her get readmission. If only he had been more available to Lily virtually, this would not have happened. So what factors stop Matthews from being available to Lily?

Outdated technology – Dr.Matthews’ clinic has a manual appointment scheduling method. Hundreds of patients call the clinic every day and the possibility of one getting an appointment is only 10%. This prevents him from catering to patients who need immediate diagnosis and attention.
Limited resources – The availability of staff is less in number. Even if Dr.Matthews recruited new people, it would increase his operating costs significantly. The use of a new technology to manage the patient traffic is also not a great idea as it is costly.
No remote patient monitoring tool – Patient readmissions can be avoided only when Dr.Matthews gives continuous care to his patients. He does not have a remote patient monitoring tool or the staff availability to handle it. Because of this, he is finding it difficult to be available to his patients.

Chronic Care Management Program

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 (CCM) program. Through Chronic Care Management program, the physician can give more attention and care to the patient.

What is Chronic Care Management?

Medicare defines Chronic Care Management (CCM) as non-face-to-face services 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.

HealthViewX Chronic Care Management solution to simplify the process

Chronic Care Management program is indeed a good idea to track your patients regularly. But when done manually, it becomes another burden for the physician. This is when a Chronic Care Management software comes to play. It reduces the time and manual effort spent in giving the CCM services. Let us consider the same scenario to explain the Chronic Care Management workflow,

The chronic patient gets sick – Lily is a diabetic patient who also had blood pressure. She fell down and hurt her head so severely that she started bleeding. As she was diabetic, the wound did not heal. She wants to visit Dr. Matthews who is her PCP.
PCP examines the patient – Dr. Matthews is a busy physician who runs a clinic. As he is Lily’s PCP, she has HealthViewX application in which she can see the doctor’s availability. She fixes an appointment with the doctor in no time. Dr.Matthews examines her and advises her to stay in the hospital for two days. The nurses there take good care of her by giving her medications on time, attending to her whenever in need, etc.
The patient gets discharged – After two days, Lily feels that she is all right. She is discharged from the hospital. Dr.Matthews prescribes her a care plan with medications and exercises to be followed strictly adhered to.
The patient is continuously monitored – Lily takes care of herself by adhering to the care plan prescribed. She gets monthly calls from the CCM team. If at all she falls sick, the application will help her to reach out to the physician as soon as possible.

HealthViewX Chronic Care Management solution features

HealthViewX Chronic Care Management solution has the following features that make the process simpler for physicians and patients,

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.

HealthViewX Chronic Care Management solution has features that suit the physicians best. 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