Extending your care and managing your population beyond the walls of your practice.

Challenges with handling CCM & TCM in-house:

Cost

Today’s healthcare environment requires a developed profit center to support any endeavor. When handled in-house, CCM & TCM can be costly and not deliver a scalable ROI.

Support

The operational infrastructure required to support a call center is costly and complex. We have built all of the components to support: Operational management structure, staff responsibilities, software and phone system infrastructure, regulatory expertise, and the space.

Time

It is not secret that healthcare providers are already challenged by the limit of time. Physicians and their staff don’t have time to buy, learn, or use new software required. Their time and resources should be focused on their patients and not building a business within a business.

Requirements

Remaining compliant with the requirements is integral in receiving reimbursements through billing. Meeting these requirements are complex and navigating the through them can be arduous.

The Renova Difference

Secure eligible beneficiary’s written consent

Beneficiary has to put in writing that the physician explained the following:

  • The nature of CCM
  • How CCM may be accessed
  • That only one provider at a time can furnish CCM for the beneficiary
  • The beneficiary’s health information will be shared with other providers for care coordination purposes
  • The beneficiary may stop CCM at any time by revoking consent, effective at end of then-current calendar month
  • The beneficiary will be responsible for any associated co-payment or deductible
The Renova Difference

Renova takes the hassle out of securing written consent by working with YOUR PRACTICE on exactly what needs you have to make this part of your process.

Have 5 specified capabilities needed to perform CCM

Those capabilities are:

  • Use a certified EHR for specified purposes
  • Maintain an electronic care plan
  • Ensure beneficiary access to care
  • Facilitate transitions of care
  • Coordinate care
The Renova Difference

We provide all of the needed infrastructure to support CCM. Working with the uniqueness of your practice, we identify the needs, opportunities, and process to ensure these 5 capabilities are implemented with ease.

Provide 20+ min. Of non-face-to-face care management services a month

The following count toward those 20 minutes:

  • Performing medication reconciliation and overseeing the beneficiary’s self-management of medications
  • Ensuring receipt of all recommended preventive services
  • Monitoring the beneficiary’s condition (physical, mental, social)
The Renova Difference

Renova provides all of the needs to ensure consistency for your chronic care management. Our MA’s are part of a team dedicated to your practice to ensure your patients are always cared for with excellence. Our team develops relationships with your patients to extend your care beyond the walls of your practice. This provides long-term impacts for both the wellness of the patient AND for the operational efficiency of the overall operation.

Complex Decision Making

Understanding of moderate to high complexity medical decision making needs during care transition

The Renova Difference

Renova’s staff of certified Medical Assistants (MA’s) are ready for patient’s leaving an inpatient setting and going home. Processes are in place to ensure we are alerted when patients are discharged so timeframes are not missed and additional work or processes are not added for the hospital staff.

Interaction within 2 business days of discharge

First interaction (can be face-to-face, by telephone, or electronic) with patient or his/her caregiver and must be done within 2 working days of discharge. If two separate attempts are made in a timely manner, but are unsuccessful and other TCM criteria are met, the service may be reported.

The Renova Difference

During the initial contact, our MA’s conduct a pharmaceutical reconciliation. The with discharge plan to consult, this step ensures patients various care plans are working together. Since this interaction must take place within 2 working days, the staff at Renova utilizes processes and systems to ensure we are alerted, have the proper documentation, and take the work from the hospital staff.

Face-to-face Interaction

Initial face-to-face interaction within described time frame (99495 = 14 days and 99496 = 7 days) and include medication management

The Renova Difference

Renova coordinates the patient’s visit to their physician to ensure compliance with billing codes. This step often is skipped as patients want to recover at home fully before going back to the doctor. Our MA’s work to coordinate the appointment within the 14-day window to ensure billing requirements.

Post-discharge services

All services from the discharge day up to 29 days post-discharge

The Renova Difference

Physicians must administer any care for the thirty days following their discharge. Once the patient does not readmit during that time, the provider of that patient can bill code 99496. We make this a viable billing experience for the doctor by taking the burdens off of infrastructure to the practice or hospital.

Talk to our team to find out more about how the Renova difference can help you!