Chronic Care Management
A recent study published in the Annals of Family Medicine finds that 40 million patients are in need of chronic care services.
The challenge is getting everything right so that your claims are not denied by the Centers for Medicare and Medicaid Services (CMS). Avoiding these issues requires being proactive and staying current on the latest trends. Here are some things we do to improve your billing practices and reduce the number of issues when it comes to chronic care management.
Eligibility is decided by those patients that have two or more chronic conditions that last for more than 12 months. These conditions must place the patient at significant risk of functional decline or death.
Another way is your patient was recently hospitalized and has a condition that lasts for 3 months to one year. Your patient should be at risk of a functional decline or death in these situations.
The CMS views the medical billing, as a specialist managing these services and billing them out as a single complex condition.
You should receive the patient’s consent at the time or before providing these services. The consent can be verbal or in writing but should be inside their medical records. Also, the CMS requires that you let your patient know about any cost-sharing and co-insurance.
These standards are complex and confusing for practitioners. We recommend contacting us, so we can help you with the medical billing and management
J3 Revenue Cycle Management is the place that lets you outsource medical billing. We understand how things are always changing and will keep you on top of everything.
All information should be documented regarding your patient’s health information using Certified CER Technology. These include things such as problems, demographics, allergies, medication, care planning, coordination, and ongoing services.
You must do a detailed assessment of your patient’s functional, medical, and psychosocial conditions. These include covering areas such as medication management, preventive care, continuity, coordination, and ensuring 24-hour access.
If you overlook anything, you could have your claim and billing denied by the CMS. These standards are changing and you must keep up with everything to maximize your profitability.
J3 Revenue Cycle Management is the premier medical billing service with over 30 years of experience. We work to support your staff, keep you informed of these changes, and reduce errors. You don’t have to worry about keeping with the new guidelines when we do all of this for you.
Every year CMS makes changes to the coding and billing practices. These come without much warning and you have to be aware of what is happening to avoid the denial of your claims.
The best approach is to outsource your medical billing to us, so we can keep you on top of what is happening.
J3 Revenue Cycle Management provides 24-hour support to you and works with your staff to keep up with everything. We streamline your revenue procedures, so you can focus on the practice of medicine.