APCM Implementation for Concierge & DPC Practices

Ensure your practice is not 'opted-out' if you intend to bill APCM for Medicare beneficiaries; hybrid models require active status.

Update patient contracts to explicitly state that APCM is a separate, billable Medicare service distinct from membership fees.

Confirm that your specific state's DPC laws allow for concurrent Medicare billing for non-covered chronic care services.

Deploy AI call handling that meets strict HIPAA standards for protecting sensitive concierge patient data during outreach.

Establish a digital system to document the 20+ minutes of non-face-to-face care required for monthly APCM billing.

Filter your current panel for patients with two or more chronic conditions who are eligible for the APCM service tier.

Align your billing codes with current CMS reimbursement rates to ensure small panel revenue is maximized effectively.

Use AI call logs to automatically capture and categorize time spent on patient coordination and proactive outreach.

Configure your EMR to distinguish between recurring membership dues and individual APCM Medicare claims to avoid double-dipping.

Document verbal or written consent for APCM services as required by Medicare, ensuring patients understand the co-pay obligations.

Tailor AI voice interactions to match the luxury, personalized tone of your concierge brand rather than generic medical scripts.

Use AI to schedule and execute proactive monthly calls, ensuring the consistent engagement required for APCM compliance.

Create brochures explaining how APCM enhances the concierge experience by adding a layer of Medicare-backed care coordination.

Integrate AI call routing to ensure patients can reach a provider or care manager at all times, a core APCM requirement.

Utilize AI to track hospital discharges and trigger immediate follow-up calls for complex patients within your small panel.