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Care management

On January 2015, CMS began paying for non-face-to-face care coordination services for Medicare beneficiaries with multiple chronic conditions under new CPT codes allowing for physicians and organizations large and small to finally be reimbursed for these services to be provided to their patients. By January 2016, information suggested that only a very small number of providers were meeting the standards to be able to bill for those services. It was clear that something needed to be done to assist others in implementing a new strategy to capitalize on the CPT codes and their corresponding standards. In November 2016, further data supported this claim as public policy moved steadily towards chronic conditions management programs that consider aspects of behavioral health and social determinants of health on patient-centered value-based models of care.


As a result of these efforts, CMS created new behavioral health codes, allowing for greater integration of chronic and complex medical and behavioral health conditions. In January 2017, these codes allowed for greater reimbursement of services provided across the continuum of care.


The Care Management implementation team at Virginia Burchett Consulting is confident that your organization has the ability to develop a fully reiumbursed CCM program and want to partner with you in achieving this goal. While working with our clients, we have determined that implementation and compliance issues are keeping providers from fully reiumbursing this new source of revenue that will allow them to improve the quality of healthcare they will provide.

Our Services

We've created a CCM implementation service that is fully customized to your organization's needs. Our dedicated and knowledgable team will work with you through an innovative project management approach that will allow you to begin enrolling and billing patients within the first month of implementation. With this offering, you will receive the following:

  • Expert consultation for all matters related to CCM
  • Personalized CCM Opportunity Assessment, which includes a complete cost-benefit analysis and return on investment (ROI) determination
  • A tailored implementation project management plan strategically created from key indicators identified in your organizations' gap analysis
  • The technology and calling services necessary to meet the criteria for reimbursement
  • A team accountable for monitoring your program's regulatory consistency and providing assistance through modifications to technology and clinical operations workflow redesign

Programs

  • Chronic Conditions Management (CCM)
  • Behavioral Health Integration (BHI)
  • Annual Wellness Visits (AWV)
  • Advanced Care Plans (ACP)
  • Transitional Care Management (TCM)


For more information on the importance of care management

MACRA AND CARE QUALITY IMPROVEMENT (pdf)Download

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