Chronic Care Management
What is CCM and how can it benefit my patients?
Chronic Care Management At-a-Glance
Chronic Care Management (CCM) is a program developed by Medicare in 2015, with the objective of providing enhanced care coordination to patients with two or more chronic conditions. This allows providers to better manage patients with complex conditions between office visits.
In certain states, state Medicaid agencies may cover CCM as well. We have successfully implemented CCM in Medicaid settings.
There are many benefits to outsourcing chronic care management:
Care Team
Care team is managed by subject matter experts who are focused simultaneously on program productivity, quality improvement, and CMS compliance.
Scalable
Contracting with Apex avoids a significant up-front investment in equipment, space, and staff.
No Risk
Practices that outsource are not at financial risk for underproductive staff or other productivity bottlenecks.
Training
Training can be difficult and time consuming, representing a significant barrier to adoption.
Our solution offers additional benefits
Proactive for Our Clients
We are proactive in growing the CCM program for our clients and identifying new qualifying patients on a rolling basis and working in conjunction with the practice to arrange initiating visits.
Full Billing Support
We offer full billing support services to our clients, including the entry of charges into your billing system, assistance with appeals, and detailed reporting & maintenance of the financial performance of CCM.
Transparency
We offer transparency in the form of regular revenue and quality reports.
Compliance Auditing
We perform regular compliance audits to ensure our clients are operating within Medicare’s parameters.
Tailored Services
Client-driven outcome tracking, reporting, and close collaboration with referring providers.
Our pricing is simple and competitive
We offer a flat rate of $26 per patient, per month regardless of the complexity of the CCM visit. The financial benefits of CCM are clear. For every 100 Medicare beneficiaries that are enrolled in the program, providers can earn up to $20,000 per year in net profit.
| Enrolled Medicare Beneficiaries | Potential Annual Net Profit |
|---|---|
| 100 | $19,200 |
| 500 | $96,200 |
| 1000 | $192,200 |
| 2000 | $384,200 |
Primary care physicians and groups, including FQHCs, are eligible for this service.
Specialists are also eligible for payment. Providers in specialties that deal with chronic conditions or treat patients frequently may find that CCM is a good fit for their practice
CCM Workflow Overview
- Comprehensive Care plan is created for the patient (Practice)
- Patient is enrolled in CCM (Apex)
- Care coordination services are performed by clinical staff in conjunction with the provider’s treatment plan and practice policies ( Apex)
- Documentation is uploaded to the practice’s EHR (Apex)
- Charges are entered into the practice’s billing system (Apex)
- Charges are submitted to insurance and flow through the billing cycle (Practice)
- Apex’s billing consultants are available to assist in resolving reimbursement issues
*Note, this is a generalized workflow. Most items below can be customized by practice preference
For More Information
If you would like more information or to set up a diagnostic appointment, free of charge, please feel free to contact us.