The case for
CCM Services is clear.
Two-thirds of Medicare patients suffer from two or more chronic conditions, and they account for 93% of Medicare spend. To tackle this problem, CMS initiated the Chronic Care Management (CCM) services program.
CCM incentivizes healthcare providers to conduct ongoing management of these patients by paying a per member per month fee for 20 minutes or more of non-face-to-face activities such as telephone consultations, prescription refills, and care coordination.
The revenue potential for participating in the CCM services program is substantial: a typical health system can expect yearly billing starting at $2 and $5 million. But many organizations fall short because of the cost and complexity of showing proof of qualifying activities.
In 2017, CMS added additional codes and changed some of the program parameters to increase participation. Despite these changes, identifying eligible activities and reporting for billing purposes is still a significant challenge.
QPID eliminates the cost and complexity of documenting and reporting CCM-eligible activities. With CCM Optimizer it’s easy to record and bill for CCM services, without adding administrative tasks to clinicians or revenue cycle staff.
Whether you’ve already launched a Chronic Care Management (CCM) program for Medicare patients, or are just exploring your options, you’ll want to ensure appropriate reimbursement for all CCM-eligible services.
CCM Optimizer uses QPID’s AI-based software and built-in EHR reporting to automatically analyze structured and unstructured data found in electronic health records, identify eligible activities, and prepare reports for billing. In addition to identifying patients that meet the CCM program requirements, the solution helps to identify gaps in care so that you can focus outreach efforts on those patients who need assistance.
- Uses information in the EHR to establish proof and maintain an audit trail of CCM services
- Requires a minimal IT lift, leveraging standard data outputs and built-in EHR reporting tools
- Is available risk-free; our fees are based on your “found revenue”
CCM Optimizer automatically finds CCM activities in the chart
Simple to implement
Find out what optimizing CCM reimbursement means to your organization.