Author Archives: Vignesh Eswaramoorthy

Ten Ways In Which HealthViewX Solution Can Fix Your Referral Management

Referral Management Process in healthcare

Patient Referral Management in healthcare plays a vital role in treating patients. The physician or the PCP identifies the need for a referral and sends it to the most relevant imaging center or specialty practice. A typical patient referral process goes through the following steps,

Referral Initiation – The referring physician usually a PCP identifies the need for a referral and initiates medical referrals. A need for a referral arises when the patient needs advanced treatment or diagnosis that cannot be provided by a PCP.
Insurance Pre-authorization – If the patient has an insurance coverage, the referring physician has to validate the same. The physician must do this to find the imaging center/specialist care practice comes under the patient’s insurance coverage. Most of the PCPs do this manually. It is a time-consuming process wherein the PCP has to wait for the insurance company to respond.
Finding the right provider – Depending on the treatment required, insurance coverage and patient’s convenience, the physician will narrow down the search and find the right receiving provider for the referral. Dr.Miller is a primary care physician. A patient visits his clinic complaining of chest pain. After the initial diagnosis, the physician refers him to a specialist for better treatment. The referring physician looks for the best cardiologist in the city. Considering the patient’s and specialist’s comfort, the referring physician initiates the referral. This the more complicated than the insurance pre-authorization step as it takes more time and effort of the PCP.
Sending out the referral – After finding the right provider, the referring physician shares the patient information and the diagnosis details with the receiving provider. The referral is sent via phone, fax, email, etc depending on the source, the receiving provider is comfortable in getting the referrals from. Most referrals are sent via fax. The PCP has to fill out a form and fax it to the receiving provider. This process takes a lot of manual effort as faxes and forms are tedious to work with.
Following up with the referral – After the receiving provider receives the referral, the specialist may communicate with the referring physician for missing information. Most of the time, the PCP may not be available to the specialist for queries. This slows down the referral process as the specialist cannot proceed with the referral. The specialist who is also a busy doctor may not have the time to update the referring physician regarding the referral. This affects the referring provider as he cannot close the referral loop or get a feedback from the patient or receiving provider.

The referral process is quite demanding for the physicians. Communicating and giving timely updates is not easy with the current workflow. Considering the complexity of referral networks, an effective Referral Management Software is the need of the hour.

How can HealthViewX help in solving such challenges?

To sum up, these challenges cause a bad experience for the patients and providers. These challenges can be addressed by the unique features of HealthViewX.

Simple referral forms – The patient demographics and diagnosis required are already in the application. The referral coordinator can create the referral through a simple three-step form.
Insurance pre-authorization process – HealthViewX automates the insurance pre-authorization process. This reduces the manual effort of the referral coordinators.
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.
Patient coordination framework – After finding the receiving provider, the referral coordinator refers the patient. When the receiving provider receives the referral, the provider will get notified of the referral. Even the patient will be notified of the referral. The receiving provider can schedule appointments based on the patient’s comfort.
Timeline View – With the help of a referral status, the referring provider can get to know what stage the referral is. A timeline view shows a history of stages through which the referral has progressed. The chances of a referring provider missing out on referral updates are very less.
HIPAA compliance – The solution is HIPAA compliant and offers secure data exchange. It supports almost all formats of files and keeps the patient documents safe.
Referral and timeline view reports – The health provider can generate the timeline view and referral analytics data as a report in any form.
Referral loop closure and feedback – The referring provider can close the referral when it gets completed. The receiving provider and the patient can give a feedback on the referral process to the referring provider. Thus the referring provider can make it easy for the other the next time.
Referral Analytics – Helps in tracking the number of referrals and gives complete information about the referrals processed, missed, scheduled etc with the help of a Referral Data-centric Dashboard.
New Referral Channels – HealthViewX supports two channels of referrals, Desktop Direct and Type-enabled pdf for sending referrals. This reduces the time and effort the physician spends in filling in forms and sending faxes. The best part is that it does not require the referring provider to use our system.

HealthViewX Patient Referral Management solution smooths the referral process and fixes most of the challenges in a referral management system. Do you want to know more about HealthViewX Patient Referral Management solution? Schedule a demo with 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.

Chronic Care Management Services In Federally Qualified Health Centers

What are FQHCs?

Federally Qualified Health Centers (FQHCs) in the United States are non-profit entities comprising of clinical care providers, that operate at comprehensive federal standards. The care providers in FQHC are a part of the country’s health care safety net, which is defined as a group of health centers, hospitals, and providers who are willing to provide services to the nation’s needy crowd, thus ensuring that comprehensive care is available to all, regardless of income or insurance status. FQHC is a dominant model for providing integrated primary care and public health services to low-income and underserved population. There are two types of FQHCs, one receives federal funding under Section 330 of Public Health Service Act and the other meets all requirements applicable to federally funded health centers and is supported through state and local grants. To receive federal funding, FQHCs must meet the following requirements.

Be located in a federally designated medically underserved area (MUA) or serve medically underserved populations (MUP)
Provide comprehensive primary care
Adjust charges for health services on a sliding fee schedule according to patient income
Be governed by a community board of which a majority of members are patients at the FQHC

What is Chronic Care Management?

The CMS introduced the Chronic Care Management program in 2015. It insisted care coordinators give 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. In order to claim CCM reimbursements, the 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

Chronic Care Management in FQHCs

It is not mandatory for FQHCs to furnish Chronic Care Management services for their patients. These services can be given in addition to any routine care coordination services already furnished as a part of the patient’s visit to FQHC. Though it is not mandatory for them to give CCM services, they can bill for the same if the CCM requirements are met.

The CCM billing for FQHCs is a little different though. For CCM services furnished between January 1, 2016, and December 31, 2017, FQHC can bill the under the CPT code 99490. Payment is based on the Physician Fee Schedule (PFS) national average non-facility payment rate for CPT code 99490. FQHC claims submitted using CPT code 99490 for services on or after January 1, 2018, will be denied.

For CCM services furnished on or after January 1, 2018, FQHCs can bill CCM services under the general care management HCPCS code, G0511. CMS has set the payment annually at the average of three national non-facility PFS payment rate for CPT codes 99490, 99487 and 99484.

It is important to note that the 2018 payment of HCPCS code G0511 is $62.28. It is high compared to the reimbursement of $42, CMS gives to practices other than FQHCs under the 99490 CPT code.

Why should FQHCs give CCM services to their patients?

Increased reimbursements – FQHCs receive grants for treating their patients. When they provide Chronic Care Management services to their patients, they get more grants from CMS. This increases the revenue for FQHCs.
Improved patient satisfaction – Chronic Care Management services establish a long-term connection with patients. The patients can reach out to the physicians at any time in need. This improves patient experience and the FQHC will see more patients coming into their hospital.

HealthViewX Chronic Care Management Software, the best fit for FQHCs

FQHCs are reluctant in giving CCM services to their patients as it is a laborious task. With increasing CCM requirements from CMS, FQHCs are worried about taking up the Chronic Care Management program. This is when an electronic healthcare product can come to play. HealthViewX Chronic Care Management solution has features that solve most of the problems faced by FQHCs.

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. Our solution manages all patient-related documents securely.

HealthViewX Chronic Care Management solution is on par with the current requirements of the CCM program by the CMS. It helps FQHCs to set up a CCM program with the least investment. To know more about our Chronic Care Management solution, schedule a demo with us.

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.

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.
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.
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.
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?

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.
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.
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,

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.
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.
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.
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.

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

Physicians Complete Guide to Chronic Care Management

Senior citizens with one or more chronic conditions have a hard time managing their health. 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 program. Patients usually visit their physicians for chronic care once or twice a year. With a Chronic Care Management program, a patient’s health improves due to increased attention and care. They can also spend less time on health issues and more on what they like to do.

What is Chronic Care Management?

Medicare defines Chronic Care Management program as non-face-to-face service 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.

Time-consuming process

Despite the increased Medicare reimbursement rates, patients do not get CCM services due to the physician’s time constraints. Chronic Care Management program requires a lot of time and effort from the physician. Unfortunately, providers must meet a number of requirements to qualify for a CCM Medicare reimbursement. These include:

Twenty minutes of non-face-to-face conversation per month with the patient
Use of a certified EHR
Create a patient care plan based on the assessments and available resources
Provide the patient with a copy of the monthly updated care plan and document the same in the EHR
Ensure that the care plan is available electronically to anyone within the practice providing CCM services
Share the care plan electronically outside the practice as appropriate
Ensure 24/7 access to care management services
Ensure continuity of care with a designated practitioner or member of the care team who will take care of successive routine appointments

The list goes on at considerable length defining the care practice must give. The fact sheet offered by the CMS goes up to eleven pages with multiple requirements to bill for CPT code 99490. This can become quite cumbersome for any practice, considering that the Medicare reimbursements are only $42.60/patient/month.

Steps to improve the Chronic Care Management program

1.Building a strong team

If a practice chooses to offer CCM services, it will be an investment. The demands include

Additional staffing with additional salaries,
Benefits and increased workload for management.
Additional office space depending on your current facility
It is important for the practice to set up a plan of action to calculate the required additional staff members required and the exact cost of this service. The practice must,
Start by assessing how many patients in the practice will be eligible to receive CCM services.
Identify how many people are needed to give quality CCM services to their patients and also additional salaries and benefits, added office space, etc.
It is important to analyze the merits and demerits from a financial perspective. Even if a practice is not profiting from CCM in the first stages, it is always possible to derive profit later.

2.Outsourcing Chronic Care Management services

Many private practices and hospitals who want to offer CCM services but cannot the implementation process can opt for outsourcing their CCM. There are vendors who provide this service and understand the new requirements better for reimbursement eligibility. In essence, they become an extension of the practice and require minimal financial investment from the provider. By this, the practice can manage the risk factors, patient experience, and profit better. A study on outsourcing chronic care management for diabetes patients found that those who participated in the outsourced care,

Rated the experience more positively
Demonstrated better clinical outcomes than those who received clinic-based care

3.Using a Chronic Care Management software

Chronic Care Management software can reduce the time and the manual effort spent in giving the CCM services. 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 Medicare reimbursements.
HIPAA compliance – HealthViewX Chronic Care Management is HIPAA-compliant. It facilitates secure data exchange. The solution manages all patient-related documents securely.

A healthcare practice following the above steps will find significant improvement in their Chronic Care Management program. HealthViewX Chronic Care Management software 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

Wolf, M. S., Seligman, H., Davis, T. C., Fleming, D. A., Curtis, L. M., Pandit, A. U., … & DeWalt, D. A. (2014). Clinic-Based Versus Outsourced Implementation of a Diabetes Health Literacy Intervention. Journal of general internal medicine, 29(1), 59-67.