Crucial Information About Chronic Care Management
In addition to our regular medical billing and revenue management services, J3 Revenue Cycle Management can also assist with chronic care management. Our team is based in Hollywood, FL, and provides these services throughout South Florida. As chronic care management becomes increasingly common, it’s essential that your billing practices and care process are correct. This prevents your claims from being denied by the Centers for Medicare and Medicaid Services. With J3RCM, you can rest assured that your billing is handled.
Eligibility for Chronic Care Patients
There are several ways in which a patient can become eligible. First, the patient can have two or more chronic conditions lasting for over a year. The patient must be at significant risk of functional decline or death due to these conditions.
Second, the patient can be recently hospitalized with a condition lasting from three months to a year. The patient must also be at risk for functional decline or death.
If a patient is eligible, certain CMS standards must be upheld. The CMS will view medical billing as a specialist managing these services and billing them as a single complex condition. The patient must give either verbal or written consent during or before their service. This consent must be listed in their medical records. The patient must be informed of any cost-sharing or co-insurance.
Documenting Health Information
Your patient’s health information must be documented using Certified CER Technology. This information includes issues and problems, demographics, medication, care planning, allergies, and ongoing services.
Additionally, the healthcare provider must assess their patient’s functional, medical, and psychosocial conditions, including medication management, continuity, coordination, preventative care, and 24-hour access.
Any oversight can lead to the denial of your claim and billing by the CMS. J3 Revenue Cycle Management can assist with the claims and billing process to ensure you maximize your profitability.
We’re only a phone call away! Call (954) 544-2706 and let us know how we can help.