Workflow GuideAdvancedMD

AdvancedMD APCM Care Plan Creation Workflow Guide

Master APCM care plan creation in AdvancedMD. Learn to automate outreach and optimize billing for independent practices using AI call handling.

Creating comprehensive APCM care plans in AdvancedMD requires specific workflow configurations to capture revenue effectively. This guide details how independent practices can utilize AdvancedMD EHR tools and AI automation to streamline patient identification, outreach, and documentation for the new APCM G-codes, ensuring compliance and maximizing practice efficiency.

The Challenge

Independent practices using AdvancedMD often miss out on APCM revenue because they lack a structured process to identify eligible patients and document the 20 minutes of monthly care coordination required by CMS, leading to administrative bottlenecks and lost income.

Step-by-Step Workflow

1

Identify Eligible Patients via AdvancedMD Analytics

Use the Reporting and Analytics module in AdvancedMD to filter by ICD-10 codes and patient age to generate a list of patients with two or more chronic conditions eligible for APCM services.

Best Practices
  • Filter by active patient status to ensure outreach is relevant
  • Save the report for recurring monthly review
Common Pitfalls
  • Ignoring patients with recent hospitalizations who are prime candidates
2

Automate Outreach with AI Call Handling

Integrate Tile's AI call handling with your AdvancedMD database to perform automated outreach, capturing patient interest and scheduling the initial care plan consultation without manual staff effort.

Best Practices
  • Personalize the AI script to mention the patient's specific provider
  • Sync appointments directly to the AdvancedMD scheduler
Common Pitfalls
  • Relying on manual cold calling which wastes clinical staff time
3

Configure APCM Custom Templates in EHR

Build custom templates in the AdvancedMD EHR that include required APCM fields such as social determinants of health, medication management, and patient-centered goals.

Best Practices
  • Use EHR macros for repetitive clinical text
  • Include a mandatory 'Time Spent' field for tracking
Common Pitfalls
  • Using generic visit templates that lack CMS-required APCM elements
4

Document and Share the Care Plan

Document the comprehensive care plan in the patient chart and share it via the AdvancedMD Patient Portal to meet the CMS requirement for patient access to documentation.

Best Practices
  • Verify patient portal activation during the initial call
  • Enable secure messaging for care plan questions
Common Pitfalls
  • Forgetting to document the status that the plan was shared with the patient
5

Map APCM G-Codes to Billing Module

Map your documented care activities to the AdvancedMD Billing module using specific G-codes like G0511 to ensure clean claim submission and automated tracking.

Best Practices
  • Test G-code mapping in a sandbox environment first
  • Audit claims weekly to ensure no coordination time is unbilled
Common Pitfalls
  • Incorrectly bundling APCM with CCM codes in the same billing cycle
6

Utilize Tasking for Monthly Follow-ups

Utilize AdvancedMD's 'Tasking' system to assign follow-up actions based on the care plan, ensuring no coordination gaps occur between scheduled visits.

Best Practices
  • Set priority levels for APCM-related tasks
  • Monitor the task dashboard to track staff completion rates
Common Pitfalls
  • Allowing tasks to expire without review, jeopardizing the 20-minute threshold

Expected Outcomes

1

Increased monthly recurring revenue from APCM G-codes

2

Reduced administrative burden on clinical staff through AI automation

3

Improved patient adherence to chronic care goals and treatment plans

4

Full compliance with CMS EHR documentation and sharing requirements

5

Enhanced patient engagement through consistent automated outreach

Frequently Asked Questions

AdvancedMD allows for custom procedure code mapping; you must ensure APCM G-codes are added to your fee schedule and linked to the appropriate provider NPIs.

No, AI handles outreach, scheduling, and 24/7 basic inquiries, allowing your care coordinator to focus on high-value clinical documentation within AdvancedMD.

While not strictly required by every payer, using the portal to share the care plan is the most efficient way to meet CMS requirements for providing documentation to the patient.

Ready to transform your advancedmd practice?

See how Tile Healthcare's AI call center can handle scheduling, triage, and patient communication for your practice.

Schedule a Demo
AdvancedMD APCM Care Plan Creation Workflow Guide | Tile Health