Workflow GuideTile Health vs ChartSpan

APCM Billing Workflow: Tile Health vs ChartSpan Comparison

Compare APCM billing and claims workflows between Tile Health's AI automation and ChartSpan's human-led model to optimize reimbursement and scalability.

Navigating Advanced Primary Care Management (APCM) billing requires precision in time-tracking and documentation. While ChartSpan relies on human care coordinators to manually log minutes, Tile Health utilizes AI to automate interaction capture and claim generation. This guide compares the workflows of these two distinct models to help practices maximize revenue and compliance.

The Challenge

Traditional CCM and APCM billing is plagued by manual documentation errors, unrecorded minutes by human staff, and high overhead costs associated with human-led service models like ChartSpan, leading to significant revenue leakage and increased audit risks for growing practices.

Step-by-Step Workflow

1

Patient Enrollment and Digital Consent

Establish the legal basis for APCM billing by capturing patient consent. Tile Health uses AI to handle automated outreach and digital signature capture, while ChartSpan uses human callers to explain the program and obtain verbal or written consent.

Best Practices
  • Use AI for 24/7 consent capture to increase enrollment rates
  • Ensure consent is timestamped and stored directly in the EHR
Common Pitfalls
  • Relying on human staff who only work business hours
  • Incomplete documentation of the APCM program benefits during the call
2

Automated Interaction and Time Tracking

Capture every second of patient interaction for billing accuracy. Tile Health's AI logs every minute automatically with precise timestamps. In contrast, ChartSpan coordinators must manually start and stop timers within their platform.

Best Practices
  • Automate time tracking to the second to avoid revenue leakage
  • Integrate phone logs directly with the billing module
Common Pitfalls
  • Manual rounding of minutes which can trigger audits
  • Forgetting to log non-face-to-time spent on care coordination
3

Clinical Documentation Synthesis

Generate the necessary clinical notes for APCM claims. Tile Health's AI produces structured summaries immediately after every call. ChartSpan requires human coordinators to write notes, which can lead to variability in detail and quality.

Best Practices
  • Standardize note formats using AI to meet BAA and HIPAA standards
  • Review AI-generated summaries for patient-specific nuances
Common Pitfalls
  • Inconsistent shorthand in human-written notes
  • Delayed documentation entry leading to forgotten details
4

CPT Code Mapping and Validation

Map the logged time to specific CPT codes like G0511 or 99490. AI ensures 100% capture of billable minutes based on logic, whereas manual models often miss 10-15% of billable time due to human oversight.

Best Practices
  • Run automated logic checks against APCM requirements before submission
  • Categorize time by activity type to justify higher-level codes
Common Pitfalls
  • Under-billing for complex chronic care management
  • Failing to separate APCM minutes from standard office visit time
5

Claim Generation and EHR Integration

Push the validated billing data into the practice's billing system. Tile Health offers deep EHR integration for automated claim batching. ChartSpan typically provides a reporting dashboard that may require manual export/import steps.

Best Practices
  • Sync billing data daily to maintain consistent cash flow
  • Verify that the billing provider NPI is correctly mapped in the AI system
Common Pitfalls
  • Manual data entry errors during export-import processes
  • Batching claims only once a month, delaying reimbursement
6

Audit Trail and Compliance Archiving

Maintain records for CMS audit readiness. Tile Health stores full digital logs and call recordings. ChartSpan maintains manual logs and coordinator notes which are more susceptible to scrutiny during audits.

Best Practices
  • Keep digital logs accessible for at least 10 years
  • Conduct quarterly internal audits of AI-generated billing logs
Common Pitfalls
  • Losing access to manual logs after staff turnover
  • Inadequate documentation of the care plan updates

Expected Outcomes

1

Reduced billing leakage through precise AI time-tracking

2

Lower administrative overhead compared to human-staffed models

3

Faster claim submission cycles with automated documentation

4

Enhanced audit readiness with comprehensive digital logs

5

Higher patient enrollment rates via automated AI outreach

Frequently Asked Questions

Tile Health typically costs 40-60% less per patient because it eliminates the high salary and management overhead of human care coordinators used by ChartSpan.

Yes, Tile Health's AI provides consistent, structured documentation that meets all APCM requirements, often providing more granular detail than manual logs.

Yes, Tile Health is designed for deep EHR integration to push billing data directly, whereas ChartSpan often requires more manual intervention for data synchronization.

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APCM Billing Workflow: Tile Health vs ChartSpan Comparison | Tile Health