In January 2015, the Centers for Medicare and Medicaid (CMS) announced a new initiative: Chronic Care Management (CCM). CCM is intended to assist clinicians in the routine care of patients with two or more chronic conditions by providing a reimbursement…
Support Services Free Clinical Staff to Focus on Patients
The clinical staff in most medical providers’ offices are a busy group. They help patients in many ways, both in the exam room and after the office visit is completed. Not only do staff set up appointments, verify insurance, and…
Discussion of Undefined Patient Qualifying Elements Under 2015 Final Rule
CMS provides broad criteria for qualifying CCM eligible patients. Does CMS define which Chronic Conditions meet the criteria for CCM? NO! The Final Rule is broad on the subject and allows physicians to make medical decisions concerning their patients. Physicians must consider the multiple chronic…
Logging CCM Services – The Audit Trail
What might an auditor be interested in seeing in order to verify that your practice has delivered the minimum 20 minutes of qualified services for CCM? In order to bill under CPT 99940, CMS has outlined many requirements. However, the…
CMS News 7/14/2015: Fraud Prevention System Yields 10:1 ROI!
This is great news for taxpayers and mandates diligence for providers. CMS audit scope is set to expend additional audit resources towards documentation and compliance! Predictive analytic tools and techniques enables CMS to move past “pay and chase audits!” …
CCM Deductibles, Cost Sharing, and Routine Waivers
CCM, PFS CPT Code 99490, is subject to patient deductibles and cost-sharing. Must providers charge and collect the patient co-pay for CCM? How much does the Provider actually receive? Click here for more information about this topic.
Chronic Care Management (CCM): Competing Consent Agreements
To date, CMS guidance leaves many unanswered questions that challenge the implementation of CCM (CPT 99490), this discussion is confined to the issue of competing consent agreements! There’s the chance, that a qualifying patient for CCM may give consent to…
Implementing Chronic Care Management (CCM)
The number of Americans with multiple chronic diseases is growing rapidly. Research studies have established that ongoing care and management of these conditions has two important benefits: improved health/patient quality of life and reduced long-term care costs when crisis care…
Posted in Articles, chronic care management, Healthcare, Publications, Resources, What's New, White Papers
Why is Chronic Care Management Important?
Your chronically ill patients receive care as your practice profitability gets some relief! The cost to taxpayers for chronically ill patients is large and growing larger each year. According to the Department of Health and Human Services (HHS) and the…
Tagged with: Business rule, CCM, chronic care, clinician, CMS, doctor, medical, physician, practice, provider
Posted in About Dulcian, BLOG, Business Rules, chronic care management, Healthcare, Resources
Posted in About Dulcian, BLOG, Business Rules, chronic care management, Healthcare, Resources
Michael Rosenblum’s OTech Magazine Cover Article
Michael Rosenblum’s article “Challenging Dynamic SQL Myths” was selected as the cover article for the Winter 2014 issue of OTech Magazine. Click here to view the Winter 2014 issue.
