APCM Billing & Enrollment FAQ for Solo Practices

A solo practice with 300 eligible Medicare patients can generate upwards of $150,000 in additional annual revenue. By using AI to handle the coordination, you keep the majority of this reimbursement rather than spending it on a full-time staff salary and benefits package.

APCM is often billed 'incident-to' the physician's services. This means that while AI or remote automated systems perform the coordination, the billing is done under your NPI. Our platform ensures all 'incident-to' requirements are met through rigorous digital logging and oversight protocols.

The AI monitors patient engagement and care minutes in real-time. At the end of each month, it generates a billing-ready report, ensuring every eligible minute is captured and submitted, preventing the revenue leakage common in solo practices that try to track time manually.

No, our solution is designed to work alongside your current EMR. We extract the necessary data for billing and push documentation back into your system, maintaining a single source of truth for your solo practice's clinical records while automating the complex APCM tracking.

With our AI solution, the physician's involvement is limited to clinical oversight and final approval of care plans. Most solo doctors spend less than two hours per month on APCM administration, as the AI handles the bulk of the coordination, patient outreach, and documentation.

Our AI call center is available 24/7, providing your patients with immediate support for non-emergency issues. This extends the reach of your solo practice, providing the same level of accessibility as a large multi-provider group without you needing to be on call personally.

The AI drafts comprehensive care plans based on patient data and clinical guidelines. As the solo provider, you review and sign off on these plans, ensuring you maintain clinical control while delegating the time-consuming drafting process to our automated system.

You must document patient consent, 24/7 access to care, and the specific care coordination activities performed. Our AI automatically logs every call, message, and care plan update, creating a robust audit trail that protects your solo practice from potential Medicare recoupments.

Yes, the system tracks every second of interaction and administrative care coordination. It alerts you when a patient is nearing the 20-minute threshold, ensuring your solo practice only bills for services that meet Medicare’s strict time requirements for APCM reimbursement.

When the AI identifies a medication issue or change during a patient call, it flags the record for your review. Once approved, the change is documented in the care plan and synced to your EHR, ensuring seamless continuity of care without manual data entry from your staff.