APCM Implementation Checklist for FQHCs | Tile Healthcare

Confirm that APCM G-codes are billed correctly alongside or outside of your daily PPS encounter rate per CMS guidelines.

Apply HRSA-required sliding fee discounts to APCM cost-sharing responsibilities for uninsured or underinsured patients.

Review your scope of project to ensure APCM services align with the federal health center program requirements.

Set up accounting sub-accounts to track APCM revenue and associated labor costs for accurate annual cost reporting.

Implement a system-wide process for documenting patient consent for APCM, ensuring it is stored in the EHR for HRSA audits.

Configure AI call agents to communicate in the primary languages of your patient population, such as Spanish, Mandarin, or Vietnamese.

Integrate Social Determinants of Health questions into AI-driven monthly check-in calls to identify barriers to care.

Provide patients with a round-the-clock AI phone line for chronic condition support, meeting APCM access requirements.

Use AI to call high-risk patients for follow-up visits, reducing no-show rates and maintaining care plan continuity.

Schedule automated AI calls within 48 hours of an encounter to track medication adherence and recovery progress.

Ensure AI call logs and care management activities directly support Uniform Data System (UDS) reporting metrics.

Define clear protocols for when the AI system should flag a patient for immediate intervention by a registered nurse.

Ensure all AI-driven patient interactions are automatically transcribed and uploaded to the patient's medical record.

Create a workflow where AI-identified social needs trigger referrals to local food banks or housing assistance.

Use AI data analytics to identify patients with uncontrolled hypertension or diabetes who require urgent care coordination.

Educate care coordinators on how to review and action the data collected by AI call agents during monthly outreach.

Assign specific providers to review APCM care plans monthly, as required by Medicare and HRSA guidelines.

Redirect routine scheduling and billing inquiries to AI, allowing front-desk staff to focus on complex patient needs.

Ensure all staff understand the security protocols surrounding AI-automated patient communications and data storage.

Regularly audit AI call logs for accuracy and patient satisfaction to ensure the technology meets FQHC care standards.