The Benefit- Improve Patient Outcomes With Care Planning

The Chronic Care Management model (CCM) entails monthly care planning encounters within primary care, which significantly contribute to improved health outcomes. This service targets beneficiaries with two or more chronic conditions anticipated to persist for at least 12 months or the patient's lifetime. Principal Care Management (PCM) follows a similar monthly care planning approach but focuses on beneficiaries with a single high-risk chronic disease expected to last for at least 3 months. Both services aim to enhance the overall health of beneficiaries, addressing their chronic conditions, physical and emotional well-being, access to healthcare, and any social challenges they may encounter. These services are delivered remotely via telephone under general supervision of the billing provider. Medicare defines general supervision as a service not personally rendered by the billing practitioner but carried out under their overall direction and control. At Prime Clinical Associates, we ensure comprehensive care management for your patients, ensuring their needs are addressed while reinforcing discussions from prior E/M visits.

Patients derive significant benefits from these services as they provide a valuable resource for addressing issues that may arise between office visits. This enables patients to voice their concerns promptly rather than waiting until their next appointment. During this care gap, our clinician can assess the CCM visit to determine whether immediate attention such as E/M services, urgent care, or emergency medical services are warranted. Our care management department consists of a multidisciplinary team comprising physician assistants, registered nurses, pharmacists, and LPNs. We strictly adhere to CMS guidelines for billing CCM and PCM services. 

Providers derive considerable benefits from these services as they serve as a secondary channel for managing more complex, high-risk patients. By offering patients additional contact points through our "extended" doctor's office, these services alleviate the workload on your in-office staff, allowing them to focus on other essential tasks. Patients enrolled in this service gain access to a 24/7 contact telephone number provided by our call center, which is advertised as your care management department. This arrangement also reduces the volume of calls received directly at your practice, streamlining communication channels and enhancing efficiency.