How To Choose The Best Chronic Care Management Company For Your Practice

The new CPT code 99490 from CMS has made it possible for your practice to get new/recurring revenue from services that are helpful to some of your most vulnerable patients that you may have been offering but not billing for. Also, providing these CCM services assists your practice in meeting the different value-based payment programs today and in the future.

Suppose you are ready to offer CCM services. In that case, you should know the program’s requirements and think twice about whether to develop the service internally or collaborate with one of the chronic care management companies specializing in CCM.

Benefits of CCM to the Patients and Providers

CCM services are still in the early stages of efforts, so if you need to become more familiar with them then you should learn about them first. Chronic illnesses are the most commonly occurring health issues in the United States especially in Medicare recipients. IN 2015, CMS began providing reimbursements to the providers for chronic disease management services. These services are different from those that are given in face-to-face visits and these services must adhere to the CMS specific regulations.

The main objective of the project is to enhance the quality of care and the results of patients with chronic diseases by offering financial incentives to providers to deliver services necessary for patients with co-morbidity. Some of the benefits of a chronic care management program include Improved results and quality of life for patients with various chronic diseases. The opportunity to generate additional revenues for services that a provider may partially offer but is not compensated for. Unnecessary healthcare cost for CMS is reduced. Reduced patient costs include copayments, deductibles, non-covered services, and monthly premiums.

Managing Chronic Care: In-House vs. Outsourcing to Specialized Companies

If you want to provide chronic care management services to your patient then you might be wondering if it makes sense to collaborate with a company having specializes in CCM services. The first step in selecting the best solution is to assess your practice’s readiness. You can consider the following points:

Enough Qualified Patients

CCM requires that the billing provider manages two or more chronic conditions for a patient and only one provider can bill for the CCM for that patient. Consider whether you have the data for supporting CCM.

Enough staff 

CCM services demand clinical professionals and you must balance the demands of CCM with the workload of your current staff. Always keep in mind that CMS wants you to give patients 7 days/week access to treatment continuity.

Expertise for CCM

To be able to provide and bill for CCM, one has to meet all the program specifications such as patient education, medication reconciliation, and working with other practitioners, among others Ensure that you and your employees have knowledge of the program and the flexibility to learn more about the program or any changes that may occur in the future.

Right Technology for CCM 

The EHRs do not yet enable various technology-related criteria for Chronic care management, like the ability to measure time spent on CCM activities, care team members’ collaboration, and submission of CCM-related claims using certified EHR technology. Make sure you have the necessary technology infrastructure to provide CCM. 

Factor in the Overhead

The last factor to look at is the tangible costs of offering the service for instance; the cost of hiring more staff, phone lines, training, and technology charges. Can you provide it at a pace that will help you make profits and still meet the demand? 

Points to Consider, in a CCM Partner

If you are planning to outsource the chronic care services from a company that specializes in CCM then search for a partner who has the following strengths:

• The capacity to deliver all-in-one CCM services with the right licensing for patient enrollment, care planning, the care delivered by nurses, and billing.

• Ability to provide your patients with 7days/week access to the facility and continuous treatment.  

• The fact that you can easily add more members to your care team, with a service that can easily address the needs of your patients and the clinical staff without any interruption to your daily operations.

If the chronic care management companies you are considering don’t meet all of these requirements, they won’t be able to help you meet the demands of a CCM program, Make sure to partner with a company that has the expertise and infrastructure necessary to help your practice successfully provide and bill for CCM services.

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