Chronic Care Management
Chronic -care management involves the study and activities by healthcare professionals helping patients suffering from chronic diseases and health conditions like diabetes, lupus, multiple sclerosis, high blood pressure, sleep apnea etc.
The CMS (Centers for Medicare and Medicaid) as on January 1st, 2015, implemented a new program of reimbursement especially for the providers taking care of chronic care management (CCM) services. To help in reducing the financial stress on the entire healthcare system, increasing the access to the primary care services for chronically ill patients was the ultimate objective.
The CMS anticipated that many physicians will take advantage of the new source of revenue. However, quite a large number of doctors are still apprehensive and are still not participating in the billing for the CCM services under CPT code 99490.
Even as they are most likely providing their services to chronically ill patients, there are several obstacles that are preventing the doctors to take ultimate advantage of the program. There are a lot of ins and outs to actually getting paid for Chronic Care Management services. To get more money, the fundamentals have to be covered.
The eligibility aspect
While it is true that CMS does not have a set pattern with the chronic diseases, they do provide a complete summary that is applicable. Patients must fall under three basic criteria:
- Patients must have at least two or more chronic conditions
- Conditions are expected to last at least 12 months or till the death of the patients.
- Conditions may place the patient at a significant risk of death, acute worsening of health condition, organ failure or further decline.
Medicare will always look to ensure that patients realize the financial implications, prospective medical services even prior to receiving the treatment. Physicians as well as non physicians like the nurse practitioners, physician assistants, and clinical nurse specialists may bill for chronic care services.
The SunKnowledge Value
To reduce you healthcare spending and recognizing the true value of Chronic Care Management will help in improving health outcomes. CPT code 99490 reimburses approximately $43 per month to the physicians and other eligible professionals for delivering at least 20 minutes of non face to face care coordination to eligible Medicare beneficiaries. CPT 99487 reimburses $94 approximately for 60 minutes of non face to face care coordination and CPT 99489 reimburses $47 approximately for additional 30 minutes.
Finding the time, the resources as well as the technology to meet your billing requirements can be difficult. Instead why not partner with SunKnowledge Services Inc, an expert in providing Chronic Care Management services billing to the patients.
- We translate the medical records that can be translated to your EHR
- We request medical records from the providers every time there is a visit
- We work as an extension to your operations, follow your preference and protocols
Leverage the SunKnowledge advantage as we ensure:
- 100s of excellent references from top clients
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- 99% accuracy rate
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- No-binding contracts
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- Fully supported by Hiscox Insurance of up to $1 million to cover any error of omission & commission
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