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Who Qualifies to Deliver Chronic Care Management Services?

Who Qualifies To Deliver Chronic Care Management Services?

When you entrust someone with the ongoing care of your patients, you need to know that person has the necessary experience and qualifications to give sound, helpful advice. Because Chronic Care Management (CCM) supports patients as they follow their physician’s care plan, the person offering the service must be able to interpret and explain recommendations clearly to the patient. They should also know how to handle administrative tasks like time tracking and billing submissions as they coordinate all the elements of the plan, including patient behavior, medication, and future appointments.

What Does CMS Require?

The Centers for Medicare and Medicaid Services (CMS) does not specify any particular credentials for those offering CCM services. However, they do require the following:

  • CCM personnel must operate under the supervision of a qualified billing provider. Qualified billing providers include physicians, registered nurses, clinical nurse specialists, and physician assistants.
  • CCM personnel must have clinical experience. Anyone offering CCM services must have the skills and training to serve patients accurately and effectively. This person must have medical training and should not be part of the administrative staff only.

These guidelines ensure that your patients receive the best possible care from their CCM provider. However, many practices find that their medical staff have full schedules already, making it difficult or impossible to add CCM to their workload. Hiring additional staff members to handle CCM tasks means you’ll be paying another full-time salary, which may not be worth it in terms of how much you receive in CCM benefits.

But outsourcing offers a better solution.

What Can You Expect From Your CCM Provider When You Outsource? 

Outsourcing your CCM management to HealthXL means that you entrust us with managing your CCM program and interacting with patients about their care plans. At HealthXL, we take that responsibility very seriously. That’s why our standards are designed to attract qualified people and to give patients the quality care they deserve. Here’s what you can expect from our service personnel:

  • CCM personnel must, at minimum, be certified medical assistants. CMS’s minimum requirement for Care Coordinators is some clinical experience, but HealthXL requires that every Care Coordinator be, at minimum, a certified medical assistant. That means you never have to worry that your patients’ care will deteriorate due to a care coordinator’s lack of medical experience.
  • Our program attracts many RNs and LPNs. Because we emphasize quality care and excellent service, our program is attractive to many qualified nurses. The benefits of CCM for patients are well-documented, and nurses come to us because they believe in the value of the services we offer.
  • We require state-specific licensing for nurses. Any nurse we hire must be licensed in the states where our clients practice. This provides peace of mind for you as you continue to provide the best possible care for your patients.

CCM improves patient adherence to care plans and health outcomes. When your patients know that someone will follow up with them, answer their questions, and check in from time to time, it helps them feel supported as they make lifestyle changes to manage their condition.

The key to achieving those outcomes, however, is having caring, experienced personnel to interact with patients. At HealthXL, we make this a top priority. Don’t let administrative burden or lack of time keep you from taking advantage of CCM reimbursement. As your trusted partner, we will help you manage the workload so you can receive the reimbursements you may already qualify for.

Contact us today to find out how we can help you take the next step in growing your CCM program.

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