When chronically ill patients have complex needs, the ChronicCareIQ system helps you proactively stay engaged with patients in between visits and captures the data you need to keep them on track.
While similar to CMS’ Chronic Care Management program, Principal Care Management (PCM) reimburses medical professionals, typically specialists, for the care management services they provide patients with a single, high-risk disease.
With ChronicCareIQ, specialists such as cardiologists or neurologists now have the opportunity to manage their patient’s disease-specific condition(s) while removing the burden of managing additional chronic conditions the patients have that are not relevant to the physician’s specialty.
Once patients are enrolled in your care management program, the system begins to proactively engage with them according to the clinical protocols you set for their specific chronic conditions. Engagement comes in the form of a series of simple questions that patients respond to – either on their phone, tablet, or personal computer.
As your team provides care and supportive services, such as phone calls, coordinating medication refills, and speaking with specialists, the system recognizes those interactions and automatically captures and timestamps each activity. Each eligible activity is then assigned the appropriate care management program codes. There is no need for staff to manually provide documentation or follow reimbursement guidelines for hitting certain thresholds – the system does the work for them.
Your clinical team members simply review their red-yellow-green dashboards to know which patients are at risk for falling out of the guidelines you’ve set and which ones need immediate attention. They can drill down to the details of each patient, review recent interactions and see the latest data coming in from patients and/or monitoring devices. This gives them a complete picture of the patient in real-time so they can make more informed decisions about what needs to happen for each patient.
Your back-office staff has access to reports that show which clinical activities were performed on which patients so preparing claims for reimbursement is simple. The system even tells them how close each enrolled patient is to fulfilling the respective CCM requirements each month.
In 2022, four new PCM codes replace the two previous PCM codes (HCPCS codes G2064 and G2065):