Workflow GuideTile Health vs Phamily

APCM Care Plan Workflow: Tile Health vs Phamily Comparison

Compare APCM care plan creation workflows between Tile Health and Phamily. See how AI automation impacts staffing and revenue for your practice.

Choosing between Tile Health and Phamily for Advanced Primary Care Management (APCM) depends on your preference for AI-led automation versus human-led care management. This guide outlines the workflow for creating and maintaining compliant care plans, highlighting how Tile Health's voice AI eliminates staffing hurdles compared to Phamily's augmentation model.

The Challenge

Manual care plan creation for APCM is labor-intensive, often requiring practices to hire new staff or divert clinical resources. While Phamily provides tools to make care managers faster, Tile Health seeks to automate the interaction entirely, solving the primary pain point of staffing overhead.

Step-by-Step Workflow

1

Patient Eligibility Identification

Both platforms sync with your EHR to identify patients meeting APCM criteria. Tile Health focuses on automated data extraction to build a priority list, whereas Phamily uses AI to surface high-risk patients for manual care manager review.

Best Practices
  • Ensure your EHR data is clean before initial sync
  • Filter by chronic condition codes to prioritize high-reimbursement patients
Common Pitfalls
  • Overlooking patients with multiple comorbidities who qualify for higher-tier APCM
2

Initial Outreach and Consent

Tile Health uses AI-powered voice agents to handle outbound calls and capture verbal consent for APCM. Phamily typically utilizes a mix of SMS and human-led calls, requiring your staff to be available to answer questions and secure enrollment.

Best Practices
  • Use Tile Health's voice AI for consistent messaging across all patients
  • Script your consent process to meet BAA and HIPAA requirements
Common Pitfalls
  • Failing to document verbal consent in a time-stamped, audit-ready format
3

Clinical Assessment and Goal Setting

The AI in Tile Health conducts structured clinical interviews to gather patient goals and health status. In the Phamily model, the platform provides scripts and dashboards to assist a human care manager in performing this same assessment.

Best Practices
  • Focus on social determinants of health (SDOH) during the assessment
  • Align patient goals with measurable clinical outcomes
Common Pitfalls
  • Creating generic care plans that do not reflect specific patient barriers
4

Care Plan Generation and Approval

Tile Health auto-generates a draft care plan based on AI interview data for physician review. Phamily's interface allows care managers to build the plan using pre-built templates, which then requires final provider sign-off.

Best Practices
  • Review AI-generated plans for nuance before final submission
  • Ensure the plan includes a clear schedule for future follow-ups
Common Pitfalls
  • Delaying provider sign-off, which stalls the billing cycle
5

EHR Documentation and Compliance

Tile Health pushes the finalized care plan and interaction logs directly into the EHR. Phamily acts as a parallel system that syncs data, requiring care managers to ensure that time-tracking and documentation meet APCM audit standards.

Best Practices
  • Verify that all 20 minutes of non-face-to-face time are logged
  • Use structured data fields rather than free-text notes for better reporting
Common Pitfalls
  • Inconsistent logging of care management minutes across different platforms
6

Monthly Care Plan Updates

Tile Health automates the monthly follow-up call to update the care plan status. Phamily alerts care managers when a patient is due for a check-in, requiring the staff member to manually initiate the outreach and update the record.

Best Practices
  • Set automated triggers for follow-ups based on the last interaction date
  • Use AI to identify changes in health status that require immediate escalation
Common Pitfalls
  • Missing monthly check-ins, leading to lost revenue and non-compliance

Expected Outcomes

1

Reduction in manual staffing requirements for care management

2

Consistent 100% documentation compliance for APCM audits

3

Increased patient enrollment via automated, high-frequency outreach

4

Higher practice ROI by eliminating the cost of dedicated care managers

5

Improved clinical outcomes through structured, AI-driven assessments

Frequently Asked Questions

Tile Health uses AI voice agents to replace the need for human callers, while Phamily provides software tools to help human care managers work more efficiently.

Tile Health is specifically designed for practices that want to implement APCM without hiring new staff, as the AI handles the bulk of patient interactions.

Typically, Phamily's revenue projections do not deduct the salary and benefits of the care managers required to operate the platform, whereas Tile Health's model has lower overhead.

Yes, both Tile Health and Phamily are fully HIPAA compliant and sign Business Associate Agreements (BAAs) with their clients.

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APCM Care Plan Workflow: Tile Health vs Phamily Comparison | Tile Health