CCM is care coordination services done outside of the regular office visit for patients with two or more chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.
Examples of chronic conditions include, but are not limited to, Alzheimer's disease and related dementias, arthritis, asthma, atrial fibrillation, autism spectrum disorders, cancer, cardiovascular disease, chronic obstructive pulmonary disease, depression, substance use disorders, diabetes, hypertension, ...
Under CCM, the patient's care team can bill for time spent managing the patients' conditions. This includes formulating a comprehensive care plan, interactive remote communication and management (usually over the phone), medication management, and coordination of care between providers.
Chronic care management requires more time and attention as it involves ongoing monitoring and coordination of care for patients with long-term conditions. Providers may already have a busy schedule and find it challenging to allocate additional time for these services.
Implementing chronic care management may require additional staff, technology, and resources, which some smaller practices or healthcare facilities may not have readily available.
The reimbursement process for chronic care management services may be complex and time-consuming, leading some providers to opt for more straightforward billing options.
Chronic care management involves documentation, coordination, and communication with patients, caregivers, and other healthcare professionals. The administrative burden associated with these tasks can be overwhelming for some providers.
Simple Care Medical Services’ Chronic Care Management (CCM) telehealth solution seamlessly integrates with physician practices and healthcare systems to provide care coordination, medication management, and consistent patient engagement.
Simple Care Medical Services alleviates physician workload and improves MIPS and APMs quality scores.
Alleviates Medicare paperwork and practice workload
Added revenue stream
Actionable clinical intelligence
Increased patient loyalty
Improved quality measures
Empowering physicians and providing them with support
No upfront costs required
We take on the workload
Decreased non-billable time.
Automated patient eligibility verification
