Chronic Care Management (CCM) Services by HealthXL®

Chronic Care Management Services

HealthXL® delivers Chronic Care Management for Medicare patients with two or more chronic conditions.
Our CCM services combine consistent virtual monitoring, phone-based follow-up and monthly
accountability to improve patient outcomes, reduce hospital readmissions and boost practice revenue.

We provide patient-centered, practice-friendly services delivered with empathy and efficiency, handling
every aspect of CCM so practices can focus on providing the best in-office care. Our expertise in care
coordination, regulatory compliance and clinical support has established HealthXL® as an industry leader.
We’ve proven our value to providers of all types, from specialists to primary care practices, and welcome
the opportunity to partner with you as well.

What is Chronic Care Management?

Every day, 10,000 Americans turn 65. Chronic Care Management relies on virtual (non-face to face) communication with those Medicare-eligible patients, who enjoy more efficient access to care and assurance they’re staying on track, while providers benefit from a more integrated care approach and a new, highly-profitable revenue stream. More features:

  • CCM services complement regular in-office visits, reducing the need for certain routine appointments
  • Improved access for patients while reducing ED visits and hospitalizations
  • 20+ minutes of remote clinical support every month by licensed nursing professionals
  • Enhanced monitoring and coordination of care between office visits
  • More consistent patient engagement
  • Increased monthly practice revenue and profitability

CCM began when the Centers for Medicare and Medicaid Services (CMS) introduced CPT billing code 99490 in 2015 to compensate providers for non-face-to-face care for patients with two or more chronic conditions.

Chronically-ill patients are accounting for the majority of all emergency room visits, many of which are preventable. Our services work to reduce those visits through preventive care. According to CMS, CCM is increasing patient and practitioner satisfaction and saving costs, but continues to be underutilized.

CCM Helps Both Patients and Providers

Reduce ED admissions and hospital readmission rates

Enhanced monitoring and coordination of care between office visits

Preventive care causes a decrease in disease progression and premature deaths

Improved access for patients while reducing ED visits and hospital readmissions

Peace of mind and reduced stress for patients with complex medical conditions

Guidance and encouragement to follow a plan of care

Reduced pressure on the practice in terms of phone calls, follow-up and access

Peace of mind in the event of a CMS audit of the practice

Chronic Care Management for Healthcare Systems

Increased practice revenue and profitability

Why Partner With HealthXL® For Chronic Care Management Services?

Effective CCM means having the know-how, systems, staff and processes to make it work. HealthXL®‘s comprehensive approach is truly A Better Way To Care:

Next-level Enrollment

Our Accelerated Enrollment Program (AEP) is essential to the success of your CCM program. We reach out directly to patients about the program’s value, while ensuring CMS compliance.

The average in-house enrollment program enrolls 10 percent or less of eligible patients, while HealthXL® achieves enrollment rates of up to 50 percent. Here’s how it works:

  • Identification of Eligible Patients: Our data team accesses your Electronic Medical Records (EMR) system to identify patients who are eligible and a good fit for CCM

  • Enrollment Calls: Our specialized enrollment team contacts patients, educating and enrolling those who consent

  • Documentation: We document patient consent for compliance purposes and provide you with outreach results

  • Updates: We review your patient population regularly to ensure all eligible patients are given an opportunity to join the program

Empathetic, Competent Patient Care

HealthXL®’s dedicated Care Coordinators focus on helping your patients reach their health objectives, providing encouragement, answering questions and connecting them to resources.

  • Convenient: Patients are contacted by their Care Coordinator at a convenient time, in the comfort of their home. We make multiple attempts to speak with patients each month
  • Proactive: Care Coordinators ask questions targeted to a patient’s specific conditions, identifying problems early, and preventing unnecessary and costly hospital visits
  • Empathetic: We train Care Coordinators for intentional listening, responsiveness and compassion. We treat each patient as we would our own loved ones. Each Care Coordinator is evaluated against this standard in our quality assurance audits
  • Effective: Our high rate of monthly patient contact maximizes adherence to care plans and provider-prescribed treatments

Improved Practice Profitability

Chronic Care Management services provide new, meaningful, recurring revenue to a practice. The national monthly average reimbursement of $61 from CPT code 99490 can significantly improve your profit margins with zero upfront financial risk to you.

We also simplify billing CMS and private insurers each month, removing the guesswork for our provider clients.

Potential financial benefits to practices associated with CCM:

  • 500 Enrolled Patients = $183,000 potential increase in profit per year

  • 1,500 Enrolled Patients = $549,000

  • Large healthcare systems can realize profit margins in the millions

The iCare Difference

Our proprietary software platform, iCare by HealthXL®, is workflow-based, ensuring all patients are serviced consistently, thoroughly and securely regardless of assigned Care Coordinator. A physician’s general or patient-specific instructions can be included with confidence.

Our workflow also integrates seamlessly with all EMRs,  and best of all, our Care Coordinators handle all administrative aspects, eliminating the need for practice staff to learn new software.

Compliance for Peace of Mind

Another feature of iCare by HealthXL® is its meticulous documentation of the time a Care Coordinator spends on patient interactions, ensuring all CCM services are fully compliant. CMS periodically conducts routine audits to validate billing practices, and we’re always prepared by maintaining extensive data trails.

The security of protected health information (PHI) is a top priority of ours, ensuring it stays private in full compliance with all HIPAA standards. To learn more about our commitment to HIPAA compliance, read this post from our Education Center blog about the A+ rating we again received from HITECH Associates, an independent cybersecurity firm that specializes in healthcare regulations.

As Chronic Care Management becomes more and more accepted as a preferred means for treating patients with chronic conditions, CMS continues to update regulations  affecting healthcare providers. We stay on top of these updates, refining our processes and letting providers know about changes affecting reimbursement and program features.

Let us show you the difference HealthXL® can make for your practice, your patients and your revenue cycle by implementing and maintaining virtual care programs.

Chronic Care Management the HealthXL® Way

We improve patient care, deepen patient-practice relationships and increase practice revenue without adding cost. If you’re interested, contact us today. Our programs can be set up and running in just a few weeks.

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Education Center
Chronic Care Management Services for Healthcare Systems

Integration With Existing EMRs

Our Virtual Care Services work side by side with your EMR software. Seamless workflow integration means not having to learn another technology or invest in new methodology. Simply access care and treatment plans dynamically through your existing EMR.

We currently work with these EMR platforms and are always expanding: