AdvancedMD APCM Billing & Enrollment FAQ | Tile Healthcare

Yes, our AI integrates with AdvancedMD to cross-reference patient lists with recent encounter data. This identifies patients who haven't been enrolled in APCM but are eligible, allowing for proactive outreach that fills revenue gaps without adding work for your front desk staff.

AdvancedMD allows for custom patient demographics and data fields. We recommend creating an 'APCM Status' field to track enrollment dates and consent. This field can be updated via API or batch import to keep your clinical and billing teams aligned on patient status.

AdvancedMD's integrated eligibility tool can check for active Medicare or commercial coverage. Tile Healthcare's AI further validates this by confirming during the enrollment call that the patient is not currently enrolled in a conflicting care management program with another provider.

By analyzing your current patient population demographics in AdvancedMD, you can forecast monthly APCM revenue. Our team helps you export this data to build a financial model that accounts for typical enrollment rates and CMS reimbursement schedules for your specific region.

Yes. Following an enrollment call, Tile Healthcare’s AI can generate a summary of the interaction and push it directly into the AdvancedMD EHR patient notes. This ensures that the clinical team is aware of the patient’s participation and that the consent is documented for billing.

The AI is programmed with your practice’s specific billing policies and CMS guidelines. It can explain that while APCM is a covered benefit, standard deductibles and co-pays may apply, helping to manage patient expectations and reduce billing disputes later.

If a patient declines, the AI records the reason and updates the patient’s status in AdvancedMD as 'Declined.' This prevents redundant outreach and ensures your practice remains compliant with patient preferences, while also providing data on why patients might be hesitant.

Yes, if a patient requires a face-to-face visit to initiate APCM, the AI can check your AdvancedMD schedule and offer available time slots, booking the appointment directly into the PM system to ensure the enrollment process is completed legally.

AdvancedMD includes time-tracking features within the EHR. For the non-face-to-face time managed by our AI and your staff, these logs should be compiled monthly. Our AI provides detailed duration logs for all patient interactions to support your billing documentation.

AdvancedMD regularly updates its EHR and PM modules to stay compliant with CMS changes. By combining AdvancedMD’s compliant platform with Tile Healthcare’s structured AI data, your practice ensures all APCM documentation meets the latest federal requirements.

Run a 'Procedure Code' report in AdvancedMD to identify all APCM claims, then cross-reference with the patient notes and consent forms. Tile Healthcare provides a secondary audit trail of AI call transcripts and consent recordings for an extra layer of protection.

CMS allows for verbal consent for APCM. Our AI captures this consent on a recorded line, and the transcript is automatically sent to AdvancedMD. This satisfies the requirement that the patient was informed of the service, the cost-sharing, and their right to cancel.