Workflow GuideNextGen Healthcare

NextGen APCM EHR Documentation & Workflow Guide

Optimize your NextGen Healthcare APCM documentation workflow. Learn how to identify patients, track time, and automate billing for chronic care management.

Mastering Advanced Primary Care Management (APCM) in NextGen Healthcare requires a precise blend of Population Health identification, Care Management module configuration, and seamless PM billing integration. This guide outlines the specific steps to document chronic care interactions and ensure compliance while leveraging AI to capture telephonic minutes.

The Challenge

Many NextGen practices struggle with fragmented APCM workflows, failing to capture non-face-to-face time accurately or missing eligible patients within the Population Health dashboard, leading to significant revenue leakage and administrative burnout.

Step-by-Step Workflow

1

Identify Eligible Patients via Population Health

Utilize the NextGen Population Health dashboard to identify patients with multiple chronic conditions. Filter by ICD-10 codes and risk scores to build a registry of APCM-eligible candidates, ensuring your outreach is targeted and efficient from the start.

Best Practices
  • Use the 'Risk Score' filter to prioritize high-need patients.
  • Sync your registry weekly to capture newly eligible patients.
Common Pitfalls
  • Relying on manual chart reviews instead of Population Health tools.
2

Configure the Care Management Module

Navigate to the Care Management module and customize the templates to reflect APCM-specific requirements. Ensure that fields for care plan updates, medication reconciliation, and social determinants of health are easily accessible for the clinical team.

Best Practices
  • Create a 'Quick Pick' list for common APCM interventions.
  • Enable 'Care Plan' notifications for the care team.
Common Pitfalls
  • Using generic CCM templates that lack APCM-specific data fields.
3

Integrate AI Call Handling for Time Tracking

Deploy AI-powered call center solutions to automatically log telephonic minutes directly into the NextGen encounter notes. The AI captures call duration and summarizes the clinical discussion, satisfying time-based billing requirements without manual entry.

Best Practices
  • Ensure AI summaries are reviewed by a clinician before signing.
  • Set up an auto-import for call logs into the CM module.
Common Pitfalls
  • Failing to log minutes for inbound patient inquiries.
4

Document Consent and Care Plans

Utilize NextGen Mobile or the EHR desktop to capture patient consent and share the comprehensive care plan via the Patient Portal. Documentation of the care plan's availability to the patient is a critical requirement for APCM reimbursement.

Best Practices
  • Use NextGen Mobile to capture consent during the visit.
  • Automate portal invitations for newly enrolled patients.
Common Pitfalls
  • Forgetting to provide the patient with a digital or physical copy of the care plan.
5

Map APCM Codes in NextGen PM

Configure the File Maintenance settings in NextGen PM to include new APCM G-codes. Link these codes to the appropriate providers and ensure that the billing engine is configured to recognize the specific modifiers needed for APCM reimbursement.

Best Practices
  • Verify that your clearinghouse supports the new APCM G-codes.
  • Test the billing workflow with a small batch of claims first.
Common Pitfalls
  • Applying standard CCM modifiers to APCM codes in the PM system.
6

Generate Monthly Activity Reports

Run the NextGen Report Writer or HQM to aggregate documented minutes and verify billing requirements are met before submission. Cross-reference documented minutes against the billing codes to ensure all requirements are met before the claim is finalized.

Best Practices
  • Schedule reports to run automatically on the first of the month.
  • Use HQM dashboards for real-time tracking of minutes.
Common Pitfalls
  • Waiting until the end of the month to review documentation gaps.

Expected Outcomes

1

Increased APCM revenue through automated time tracking and AI call logging.

2

Reduced administrative burden on clinical staff using automated encounter summaries.

3

Improved compliance with CMS documentation standards for chronic care.

4

Enhanced patient engagement via the NextGen Patient Portal and care plan access.

Frequently Asked Questions

AI solutions use API integrations or secure HL7 feeds to push call logs, duration, and clinical summaries directly into the NextGen Care Management module or encounter notes.

While similar, APCM has unique documentation requirements. It is recommended to clone your CCM templates and update them with specific APCM G-code mapping and updated clinical goal fields.

Combining NextGen's built-in time tracking fields with automated AI call logs ensures every minute spent on the patient's care is captured accurately for billing.

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NextGen APCM EHR Documentation & Workflow Guide | Tile Health