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CCM Program Setup

Setting up a new patient in CCM

Bill Ruby avatar
Written by Bill Ruby
Updated over 2 months ago

Once your patient is added into the practice, you are now ready to begin the Chronic Care Management (CCM) program. The Program Setup workflow circles will outline the steps required to initiate the patient into the CCM program.

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Enrollment and Consent

First, you must enroll the patient into the CCM program. Enrollment can be started by either selecting the Enroll next to the CCM program name or by selecting the Enrollment and Consent circle.

Once a user begins enrollment, the CCM Enrollment Status modal will display.

Since we are enrolling a patient in CCM, select Active from the drop down menu.

Once the CCM enrollment is set to Active, additional enrollment information will appear below the Change Enrollment Status to dropdown.

Review all items listed in the Patients must consent and agree to the following section with your patient. Check each box as you go.

Note: CMS requires clinicians to review all checkbox items listed with the patient to obtain consent. All checkboxes must be selected to indicate the patient has agreed to the CCM program in order to continue.

Once all consent items have been checked, confirm if the patient's consent was Verbal or Written.

Select the Care Manager who is completing the enrollment by clicking the Updated by dropdown.

Select the start date of the CCM program by clicking the Start Date box.

Note: The start date will default to today's date. Users are unable to select dates in the future.

Click inside the Note textbox to add additional comments related to the patient's CCM enrollment.

Lastly, Patient is Billable will default to checked. If the patient will be billed for the CCM program leave the checkbox checked. If the patient will not be billed for services they receive, click to deselect the Patient is Billable checkbox.

Note: By unchecking this checkbox, no claims will be created for this patient even if they fulfill the time log requirements to be billable for CCM.

Once all CCM Enrollment fields are complete, click the Save button in the bottom right corner.

Under Program Setup, the Enrollment and Consent circle will now update with a green checkmark to indicate that it was successfully completed.

Assign Care Team

The Assign Care Team modal will display next to assign the members of the care team to the patient.

Select the appropriate Care Manager from the Care Manager dropdown.

Select the appropriate Physician from the Physician dropdown.

Select Save in the bottom right corner to continue.

Under Program Setup, the Assign Care Team circle will now update with a green checkmark to indicate that it was successfully completed.

Identify Program Conditions

Lastly, the Edit Patient Conditions modal will display to identify the chronic conditions you wish to include in the patient's CCM program.

Select Add condition to begin adding conditions.

Select the condition from the dropdown menu and repeat for each additional condition associated with the patient.

Once all conditions have been added, select Save & Close in the bottom right corner to save the conditions to the patient.

All three Program Setup circles are now complete. This patient will now be ready for the Initial Monthly Workflow.

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