APCM Compliance Checklist for Obesity & Weight Management

Confirm and document a BMI of 30 or higher within the last 12 months as per Medicare requirements for chronic care.

Explicitly associate obesity with at least one other chronic condition like Type 2 Diabetes, Hypertension, or Sleep Apnea.

Secure and store signed patient consent specifically for Advanced Primary Care Management services in the EHR.

Create a structured weight management plan including caloric goals, physical activity targets, and medication schedules.

Use automated systems to record and transcribe the initial enrollment call to provide a clear audit trail of verbal education.

Document every dosage change for medications like Wegovy or Mounjaro to justify medical necessity and clinical oversight.

Utilize AI-driven phone prompts to screen for common GLP-1 side effects such as gastroparesis, nausea, or pancreatitis signs.

Record monthly weight measurements to track progress and adjust clinical interventions or medication levels accordingly.

Confirm patients are filling and administering injections on the prescribed schedule through automated check-in calls.

Monitor expiration dates for GLP-1 authorizations to prevent gaps in therapy that impact clinical outcomes.

Track and document adherence to mandatory bariatric vitamin and mineral supplementation protocols to prevent deficiencies.

Document patient reports of daily protein consumption to ensure maintenance of lean body mass post-surgery.

Use AI triage workflows to identify early signs of strictures, dumping syndrome, or nutritional emergencies.

Log minutes spent on behavioral weight counseling and lifestyle modification coaching during monthly calls.

Schedule and track annual blood panels for long-term bariatric patients to ensure metabolic and nutritional stability.

Ensure AI call logs and staff interaction notes accurately total the required monthly clinical staff time for APCM.

Store all AI-handled patient interactions in a secure, encrypted environment for rapid retrieval during a Medicare audit.

Update the obesity care plan at least quarterly based on weight loss velocity and changes in metabolic health markers.

Document that all APCM activities are performed under the general direction of the billing physician or NP.

Maintain the ability to quickly export timestamped call transcripts and clinical notes for CMS or RAC audits.