Chronic Care Management

CloudMD365 provides turn-key, fully managed care coordination programs for your patients. We leverage your care coordination program to deliver high scoring MIPS compliance.

 

We don't get paid, until you get paid.

 

We Help Take Care of Your Patients In-between Office Visits

  • LOYALTY

    Your patients already love you. Ensure that love never ends by giving your most needful patients access to customized care between office visits.

  • OPTIMIZE

    Our cloud-based platform ensures the most up-to-date care for your loved ones.

  • SOCIAL DETERMINANTS

    Go beyond social health assessments and deliver meaningful mobility, community, finance and need-based solutions to your patients.

  • SAVINGS

    Value-based care requires providers reduce the cost burden. A well-run patient care coordination program has proven to deliver savings, increasing your reimbursements.

  • RETENTION

    By providing your patients with care tools they truly value, you minimize patient churn and build long-lasting relationships with your patient panel.

Benefits of a Chronic Care Management Program

  • Data-proven improvements in patient outcomes

  • Patient outreach services drive patient retention and loyalty

  • CMS strongly supports new CCM service models and reimbursements

  • CCM drives increase in meaningful, reimbursable, in-office E&M encounters

  • Increase in Medicare Shared Savings Program attributable beneficiaries

  • Improves accuracy of patient risk scoring, impacting capitulated reimbursements models

  • CCM improves MIPS and APM quality measure scoring

graph-resized

EARN RECURRING REVENUE

CloudMD365 provides all of the benefits of Chronic Care Management, with none of the hassles. With reimbursement rates ranging from approximately $40 to $142, Medicare’s Chronic Care Management bill code 99490, 99487, and 99489 afford practices the opportunity to create a new profit center while improving the experience and clinical outcomes for patients.

  • No upfront money

  • No software or hardware to purchase

  • No new staff to hire

  • Contingency pricing – we don’t get paid until you get paid.

Turn Key CCM

24/7 Patient Access

laptop

Web portal for patient and provider

Clipboard

Custom Patient Care Plans

Secure File Sharing

paper

Simplified CCM Billing for Providers

How does it work?

We provide the services, you collect from Medicare, we charge a percentage of what you collect.

What is CCM?

Chronic Care Management is a program created by CMS to give extra care to patients with multiple chronic conditions.

A robust CCM program reduces readmission rates.

CMS reimburses Primary Care givers for services provided. Previously, these reimbursements are typically too low for a practice to implement the plethora of changes needed to create a successful CCM program.

CloudMD365's Turn Key CCM program makes CCM profitable for any size practice.

 

CCM Software Designed with clinicians in mind.

Find out why practices everywhere are choosing CloudMD365 to simplify their Chronic Care Management program:

  • Your own secure, HIPAA-compliant software portal

  • Unlimited users and patients

  • Live Dashboard showing current CCM minutes

  • Patent-pending Guided-interviews for CCM Care Plans

  • Task tracker (with timer) and Time Logging

  • Monthly Update interface for clinical staff and providers

  • Create Care Plan reports for patient and other providers

  • Easily download summaries and upload to your EHR

  • Integrates with Annual Wellness Visit Software

  • Easy Billing interface to easily submit 99490 claims

  • Tech Support via email and phone

cloudmd_laptop_2

Why CCM Programs Are So Effective

  • EMERGENCY ROOM UTILIZATION

    ER utilization rates were 13% lower for patients enrolled in a care coordination program.

  • MORTALITY RATE & HOSPITAL COST

    Annual mortality rates and hospitalization costs 20% lower for patients enrolled in a care coordination program

  • CARE COORDINATION PROGRAMS

    $101 per month, per beneficiary reduction in Medicare spending (or 6% per patient)

care-caregiver-deal-45842

READY TO GET STARTED?

Find out how much you could save using our CCM Cost Calculator.

Frequently Asked Questions

What is Chronic Care Management?
+ -
Chronic Care Management, at least when speaking in the context of Medicare billing code 99490, is providing non face-to-face care for chronically ill patients between office visits in an effort to address all of the issues that may impede a patient’s ability to manage their conditions and adhere to the care plan. Fundamentally, it is designed to provide enhanced care for the patients most in need who account for the highest utilization (highest cost).
What is required of the provider?
+ -
Per the CMS Final Rule, "Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; comprehensive care plan established, implemented, revised, or monitored."
Which patients are eligible?
+ -

Any Medicare patient with 2 or more chronic conditions is eligible for this program. CMS intentionally left the definition of “chronic conditions” open to discernment by the provider. CMS guidelines simply requires the patient to meet the following criteria:

  • Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
  • Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation
Which providers are eligible to bill for CMS Chronic Care Management billing code 99490?
+ -

CMS did not limit chronic care management to one practice area. While primary care is the most logical place, any provider can implement and bill for chronic care management. Gynecology and gastroenterology that may have a patient population that can support a chronic care management program. Conversely, chronic care management may not be a good fit for surgeons as there are limitations on what can be billed for during the post-op period.

Can I do this myself?
+ -

The complexities of Chronic Care Management are numerous, from adopting the right technology to achieving efficiency and to mitigating the risk of audits to the allocation of resources to adequately meet the needs of your patients and requirements of the program. While some practices attempt to do it themselves, most fail. Here are just a few considerations:

  • Requires a minimum of 20 minutes per month. However, in reality, it requires significantly greater care—in the range of 30-40 minutes.
  • Requires you to provide patient access to clinical staff 24/7/365
  • Would likely require you to adopt new technology, requiring a capital investment and causing your staff to learn yet another software application.
  • Requires maintaining detailed records of all care coordination that CMS may require you to furnish upon an audit.
  • Depending on your practice size, it may require a large clinical team, requiring space your may not have or are not willing to allocate to this program.
How much time will my staff & I have to allocate to Chronic Care Management?
+ -

CloudMD365 has designed a program to minimize the time demand on your practice. We custom tailor our programs based on the amount of interaction/involvement each provider wants. You will spend time in three areas: enrolling patients, reviewing care plans (optional), and submitting billing to CMS for reimbursement. We handle everything else! And, because we are staying in contact with patients between office visits, we are able to eliminate many of the phone calls, activities your staff would normally handle.

Will I bill for fewer encounters?
+ -

The simple answer is no. While it is possible a few patients may be able to avoid office visits because they are now able to better manage their chronic conditions, we will be actively promoting the annual wellness visits as part of our care plans. You should expect to bill for considerably more wellness visits once the chronic care management program has been implemented.

How do we enroll patients?
+ -

With CloudMD365, the patient enrollment process has been designed for extreme efficiency. From identifying which patients are eligible and coordinating visits with the front office to obtaining a signature on the patient consent form, our process was designed to minimize the friction. We provide practices professional patient materials to educate your patients and facilitate enrollment when the service is prescribed.

When can the patient be enrolled?
+ -

CMS requires the billing practitioner to furnish an Annual Wellness Visit (AWV), Initial Preventive Physical Examination (IPPE), or comprehensive evaluation and management (E&M) visit to the patient prior to billing for Chronic Care Management billing code 99490. The practitioner must initiate the Chronic Care Management service as part of the exam/visit.

What if a patient is already enrolled in Chronic Care Management with another provider?
+ -

Only one provider may bill on any given month. This requirement is clearly outlined on the consent form. To be eligible to participate, the patient would need to withdraw from the other program prior to enrolling in your chronic care management program. This underscores the urgency to begin a chronic care management program sooner rather than later. You don’t want to have this opportunity pass you by.

What services do you provide during the 20 minutes?
+ -

At CloudMD365, we focus on the services that provide the greatest gains in health and well-being. Beyond building the custom care plan, a requirement of 99490, we strive to achieve continuity of care for the patient across all providers. Care Coordinators are available 24 hours per day, 7 days per week, via phone, email, and in-app messaging to help patients schedule appointments with the designated provider and ensure comprehensive health information is consistently shared with the entire care team.

Based on the patient’s unique needs, we perform a series of assessments and update the care plan accordingly. We gather key insights from the client and create tasks, medication & measurement reminders, etc. to help the client better manage their chronic conditions.

Is your technology HIPAA-Compliant?
+ -

Yes!

Do I have to change my EMH/EHR
+ -

No. CloudMD365 is not an EMR, nor do we require you to change yours if the EMR is 2014 meaningful use certified. As the only Chronic Care Management solution on the market with enterprise class integration capabilities, we are able to interface with your EMR to gather the information we need and then build a comprehensive, longitudinal record within our proprietary care coordination platform.

How do you comply with the CMS electronic communtion requirements?
+ -

CloudMD365's care coordination platform was purpose built to help providers transition to and thrive in all forms of value-based care. As such, it possesses the latest technologies for the electronic sharing of patient records and communication.

Are there any instances when you will not be able to bill for Chronic Care Management in a given month?
+ -

Yes. There are four types of services that would prevent us from billing for Chronic Care Management for a given month, as the care management component is built into these services already:

  • Transitional Care Management (99495, 99496)
  • Home Healthcare Supervision (G0181)
  • Hospice Care Supervision (G0182)
  • Certain ESRD codes (90951-90970)
Which payers will pay for billing code 99490?
+ -

Medicare and Medicare Advantage plans. Some Medicaid programs also offer some variations of a chronic care management program. Also, commercial plans are evaluating chronic care management and may adopt similar programs in the near future.

What is the reimbursement rate?
+ -

The average reimbursement is $41.44. This amount varies by location. See our revenue calculator to find the reimbursement rate in your area. The 2015 Medicare physician fee schedule assigns 0.61 relative value units (RVUs) to code 99490.

If we don't meet the 20 minutes for a given month, but our work over two or three months adds up to 20 minutes, can we bill at that time for a month?
+ -

No. Code 99490 is for 20 minutes “per calendar month.” You cannot add time up over multiple months to report 99490.