Solo Practice APCM Documentation Checklist

Confirm active Part B enrollment for the primary billing provider to ensure the solo practice can successfully submit APCM claims.

Document that the patient was informed of cost-sharing and their right to stop the service at any time during the solo practice visit.

List at least two chronic conditions expected to last 12+ months or until death as per CMS guidelines for advanced management.

Ensure the patient understands potential copays and that you, as the solo practitioner, are the sole billing entity for this service.

Explicitly state that the solo practitioner is the primary manager of the patient's chronic conditions within the medical record.

Include all active medical problems, including those managed by external specialists, to maintain a holistic view of the patient.

Set measurable health goals specifically tailored to the patient's lifestyle and the solo practice's specific clinical capabilities.

Maintain a comprehensive list of prescriptions, OTC meds, and allergies updated during every care interaction for patient safety.

Document barriers like transportation, food insecurity, or housing that affect care plan adherence for independent patients.

List all external providers and the specific protocols for sharing the care plan with the patient's specialists to ensure continuity.

Record how the patient can reach the practice after hours via AI-powered call routing or automated triage systems.

Use AI logs to track non-face-to-face time spent on patient-related administrative and clinical tasks for billing accuracy.

Log automated check-ins performed by the AI system to monitor patient status and adherence to the care plan monthly.

Document follow-ups after ER visits or hospital discharges, ensuring the solo provider reviews all transition notes within 7 days.

Maintain a detailed record of all digital and phone communications within a HIPAA-compliant environment for audit protection.