NextGen APCM Implementation Checklist | Tile Healthcare

Ensure G0511 or specific APCM codes are added to the NextGen PM Master Files with correct fee schedules for your specific geography.

Configure the system to automatically append necessary modifiers for chronic care management to ensure clean claim submission.

Verify that APCM codes are correctly mapped to the appropriate NPIs within the NextGen practice configuration for accurate reporting.

Set up PM alerts to prevent duplicate billing of APCM codes within the same 30-day calendar period for the same patient.

Document and input payer-specific billing rules into the NextGen Rules Engine to handle variations in APCM coverage.

Utilize the NextGen Population Health tool to identify patients with two or more chronic conditions meeting CMS criteria.

Create custom SQL reports or use NextGen Report Writer to filter patients by diagnosis codes and their last visit date.

Use the 'Care Management' status field in NextGen EHR to flag patients who have consented to APCM services for easy filtering.

Review NextGen risk scores to prioritize high-need chronic patients for immediate APCM enrollment and outreach.

Export eligible patient lists from NextGen to your AI call handling system to automate the initial enrollment outreach process.

Modify NextGen EHR templates to include mandatory fields for care plan updates and non-face-to-face time tracking.

Set up NextGen templates to pull existing problem lists and medications into the APCM care plan automatically to save time.

Use NextGen Tasking to route APCM follow-ups and care gap closures to the designated care management team members.

Implement a standardized method within the NextGen EHR encounter to log the cumulative minutes required for APCM billing compliance.

Ensure providers receive care gap alerts via NextGen Mobile to discuss APCM during face-to-face visits with eligible patients.

Deploy AI voice agents to conduct monthly APCM check-ins, capturing patient responses directly into NextGen EHR notes.

Use AI call handling to reduce no-shows for APCM-related follow-up appointments scheduled in the NextGen PM system.

Provide patients with 24/7 access to a care coordinator via AI phone automation to meet CMS accessibility requirements.

Use AI to call eligible patients, explain APCM benefits, and record verbal consent for documentation in the NextGen chart.

Ensure all AI-driven patient interactions are automatically logged as documents or encounters within the NextGen patient chart.