ModMed APCM Billing & Enrollment Guide | Tile Healthcare

The AI performs outbound calls to eligible patients identified in ModMed, explaining the benefits of APCM and obtaining the necessary verbal consent. This process is recorded and summarized, with the enrollment status automatically updated in the ModMed patient record.

While ModMed provides the platform for documentation, Tile Healthcare provides the automation. Our AI handles the heavy lifting of patient education and consent gathering, then pushes the signed or verbal consent documentation into the ModMed document management system.

Common qualifying conditions found in ModMed specialty practices include chronic inflammatory diseases, osteoarthritis, chronic kidney disease, and severe asthma. Our AI is configured to recognize these ICD-10 codes within your ModMed database to prioritize outreach.

Yes, the ModMed patient portal can be used to send follow-up information after an AI-driven enrollment call. Tile Healthcare can trigger portal messages that include APCM program details, ensuring patients have a digital reference of their enrollment.

Tile Healthcare’s AI checks for existing care management enrollment during the initial outreach. By documenting these findings in the ModMed 'Internal Notes' or 'Care Coordination' fields, we help your billing team avoid dual-billing conflicts with the patient’s primary care provider.

Specialty practices on ModMed often see a significant revenue increase by capturing APCM reimbursements for their existing chronic patient base. By automating the monthly outreach and documentation, the overhead is minimized, allowing the practice to retain more of the APCM payment.

AI automates the tracking of non-face-to-face time, which is a key requirement for APCM. Instead of staff manually logging minutes in ModMed, the AI automatically records the duration and nature of every patient interaction, providing a ready-to-bill log for the end of the month.

Yes, ModMed is a certified EHR that meets CMS requirements for APCM billing. When paired with Tile Healthcare’s automated documentation, your practice can confidently meet all compliance standards, including the 24/7 access to care requirements.