Chronic Care Management (CCM)

Medicare has published its final rule for 2015 that specifies the reimbursement physicians will get for providing care to chronically ill patients under the new Chronic Care Management (CCM) program.  It’s a good deal for physicians in that it can bring in a substantial amount of new revenue each year.  However, physicians need to be aware that CCM reimbursement applies to patients who have certain chronic conditions.

Specifically, the agency has agreed to pay a per patient payment of $41.92 that can be billed no more than once per month for patients with two or more chronic conditions.

To bill for the services, the following are required:

– Documentation in the patient’s medical record that all of the chronic care management services were explained and accepted by the patient;

– A written agreement that electronic communication of the patient’s information with other treating providers is part of care coordination;

– Information about the availability of the services from the practitioner; and

– A written or electronic copy of the care plan that is provided to the beneficiary and recorded in the electronic health record (EHR).

WellTrackONE can help practices identify those patients with 2 or more chronic conditions very easily.  Using the Medicare Annual Wellness Visit as a baseline service, WellTrackONE will reach out proactively to all your active AND inactive Medicare patients (Part B and Medicare Advantage) and attempt to conduct a wellness assessment for those patients.  The reports generated by WellTrackONE AND the WellTrackONE Reportal quickly identify those patients with 2 or more chronic conditions.

Once WellTrackONE finishes producing the approved Medicare report for the Annual Wellness Visit, the practice can scan the report’s “Risk Factor” section and quickly see which patients are at risk for or have chronic illnesses or co-morbidities.  Once those patients are identified, they can be put in the CCM program immediately.

If the practice has already processed its Medicare patients and doesn’t have time to scan each WellTrackONE report, they can simply run the “Risk Factor Matrix” report that is embedded in the WellTrackONE Reportal.  All patients with high or severe risk of chronic illnesses are easily stratified and identified on that report.

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