Who Is Eligible To Receive Chronic Care Management And How Are Patients Enrolled

Story by Connor Danielowski / March 29, 2019

Chronic Care Staffing established a Chronic Care Management Program for providers to help provide non face-to-face care to patients that met eligibility requirements for Chronic Care Management as defined by Centers for Medicare and Medicaid Services (CMS). CMS recognize Chronic Care Management (“CCM”) as a critical component of primary care that contributes to better health and care for individuals. 

The qualifications to be eligible for CCM are defined as patients having multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient and that these chronic conditions place the patient at significant risk of death, acute exacerbation / decompensation, or functional decline. Furthermore, a comprehensive care plan must be established, implemented, revised, or monitored. 

CCM services include at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month to each patient that has met the conditions outlined by CMS to be eligible for CCM.

In 2017, CMS allowed for Patient Verbal Enrollment to initiate CCM services.  For new patients or patients not seen within one year prior to the start of CCM, Medicare requires an annual wellness visit (AWV) and allows for CCM enrollment reimbursement during a face-to-face visit with the billing practitioner and is separately billed.

Chronic Care Staffing will help with increasing Patient Education/Awareness, identifying Patients in need of their Annual Wellness Visit (AWV), assisting with medication refills/reconciliation, assisting with verbal enrollment maximizing CCM patient participation, assisting with appointment reminders, documenting and reporting change in patient health status, referral coordination, and transition of care notice to provider.

Find out if a CCM Program is right for your facility. Chronic Care Staffing can help generate more revenue for your business and improve overall healthcare to your patients, in turn improving patient health outcomes.

888-254-4435


About the Author

Connor Danielowski

Chief Operating Officer, Chronic Care Staffing

Connor Danielowski is the Chief Operating Officer at Chronic Care Staffing, where he leads operations, strategy, and growth initiatives focused on delivering high-impact virtual care solutions. He brings a unique blend of clinical service knowledge and financial expertise to help healthcare organizations implement and scale Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and other virtual care management services.

Connor began his career in investment banking and private equity, where he focused on investing in healthcare businesses and working closely with management teams to drive revenue growth and profitability. This experience shaped his hands-on, results-oriented approach to healthcare operations today.

He holds a degree in Accounting from Washington & Lee University and brings both analytical rigor and a patient-first mindset to his role. In addition to his work at Chronic Care Staffing, Connor serves on the development board for the MUSC College of Nursing. He lives in Charleston, SC, with his wife and son.


 
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