Healthcare ISV’s are incentivized to offer Chronic Care Management (CCM) feature to help providers reduce readmissions and monetize on reimbursements (ranging from $42 to $92) against CPT code 99490, 99487, 99889 and HCPCS G0506 per month. Chronic conditions account for 86% of all healthcare expenditures, and 68% of Medicare beneficiaries have two or more chronic conditions.

Healthcare ISV’s have identified this as new source of revenue and a value addition that can be offered to their clients. Development time required to build CCM as a feature into their product is between 9-12 months. Faichi offers CCM accelerator with predefined business logic and workflows that significantly reduces the time to market to 3-4 months.

The CCM framework covers from the first step of identifying eligible patients to getting reimbursed (billing). We understand the details of CCM program (as described below) and its benefits which can be leveraged by the providers.  Our solution can be customized and delivered as a standalone CCM tool or Integrated within an existing Healthcare product (ISV).

 

Chronic Care Management

Benefits of CMS’ CCM program:

  • Increased revenue for provider, $42 to $92 for relevant CPT codes.

  • Better health outcomes and reduced healthcare cost.

  • Better care coordination and patient engagement

Chronic care eligibility criteria for patients:

  • Patient diagnosed with 2 or more chronic conditions (Hypertension, Diabetes, Heart Disease, etc) for over a year.

  • Chronic conditions that put patient at high risk of death or acute exacerbation.

Chronic care eligibility criteria for providers:

  • Eligible Practitioners:

    1. Physicians

    2. Certified Nurse Midwives

    3. Clinical Nurse Specialist

    4. Nurse Practitioner

    5. Physician Assistance

  • Only one Practitioner will be paid for CCM services (CPT 99490, 20 minutes or more of non-face to face consulting service) for a given calendar month.

  • Providers can also leverage secure video conferencing platform for CCM service.

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