Workflow GuideAdvancedMD

APCM Patient Enrollment Workflow for AdvancedMD Users

Master APCM enrollment in AdvancedMD. Learn to identify eligible patients, configure billing, and use AI for outreach to maximize practice revenue.

Transitioning to the Advanced Primary Care Management (APCM) model within AdvancedMD requires a structured approach to patient identification and enrollment. By leveraging AdvancedMD's reporting tools alongside AI-driven communication, practices can efficiently enroll eligible Medicare beneficiaries and secure recurring monthly revenue without increasing administrative burden.

The Challenge

Many AdvancedMD practices struggle to identify APCM-eligible patients and manage the high volume of outreach calls required for enrollment, leading to missed revenue and underutilized billing modules.

Step-by-Step Workflow

1

Identify Eligible Patients via Report Center

Utilize the AdvancedMD Report Center to run a custom query filtering for Medicare beneficiaries with two or more chronic conditions. This data export serves as the foundation for your outreach list, ensuring you target patients who qualify for APCM reimbursement.

Best Practices
  • Filter by Payer Type: Medicare
  • Use ICD-10 cross-referencing for chronic conditions
Common Pitfalls
  • Forgetting to exclude patients already enrolled in CCM
  • Using outdated patient contact lists
2

Deploy AI-Powered Outreach

Instead of manual staff calls, use AI automation to reach out to the exported list. The AI explains the APCM program benefits, answers common questions, and captures verbal consent, significantly reducing the workload on your front desk staff.

Best Practices
  • Schedule calls during peak engagement hours
  • Ensure the AI script emphasizes zero-cost preventative benefits
Common Pitfalls
  • Using overly technical medical jargon in the AI script
  • Not providing an option for the patient to speak to a live human if requested
3

Document Consent in AdvancedMD EHR

Once consent is obtained via AI, update the patient's record in AdvancedMD. Use a specific APCM Enrollment flag or note type in the demographics tab to ensure visibility for the clinical and billing teams during the monthly cycle.

Best Practices
  • Create a 'Patient Note' template specifically for APCM consent
  • Link the consent date to the patient's chart
Common Pitfalls
  • Failing to timestamp the verbal consent documentation
  • Not attaching the AI call transcript to the patient record
4

Configure APCM G-Codes in Master Files

Navigate to the AdvancedMD Master Files to configure the new APCM G-codes. Ensure that the billing profiles are updated so that these codes can be easily selected on charge slips without manual entry errors or denials.

Best Practices
  • Check CMS updates for the latest APCM-specific G-codes
  • Set up automatic charge triggers if using AdvancedMD automation
Common Pitfalls
  • Using generic CCM codes instead of specific APCM G-codes
  • Incorrectly mapping the code to the wrong provider NPI
5

Create APCM Care Plan Templates

Implement a customized APCM Care Plan template within the AdvancedMD EHR. This template should include fields for goals, medication management, and social determinants of health to satisfy CMS audit requirements.

Best Practices
  • Use 'Smart Phrases' to speed up documentation
  • Include a checkbox for patient agreement to the care plan
Common Pitfalls
  • Leaving the care plan too generic
  • Not updating the care plan after the initial enrollment encounter
6

Establish Time Tracking Protocols

Implement a process for tracking the required monthly care coordination time. Use the AdvancedMD Time Tracking feature or specific task categories to ensure every minute spent on the patient is documented for billing.

Best Practices
  • Train staff to log time immediately after any non-face-to-face activity
  • Use AdvancedMD's 'Tasks' to assign follow-ups
Common Pitfalls
  • Under-reporting time spent on care coordination
  • Failing to reconcile tracked time with the final monthly claim

Expected Outcomes

1

Increased monthly recurring revenue via APCM G-code billing

2

Improved patient engagement scores within AdvancedMD analytics

3

Streamlined administrative workflows for front office staff

4

Higher compliance with CMS documentation standards

5

Reduced staff burnout through AI-driven patient outreach

Frequently Asked Questions

You can identify eligible patients by running a custom report in the AdvancedMD Report Center, filtering for Medicare Part B coverage and specific ICD-10 codes associated with chronic conditions.

Yes, TileHealthcare's AI integrates with your AdvancedMD patient lists to conduct automated outreach, explain the APCM program, and capture the necessary verbal consent for enrollment.

You should primarily configure G0511 and other relevant APCM codes as defined by the latest CMS Physician Fee Schedule. Ensure these are added to your Master Files for easy selection.

While AdvancedMD doesn't have a standalone APCM module, its existing Billing and EHR modules can be fully customized with templates and codes to support a complete APCM workflow.

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APCM Patient Enrollment Workflow for AdvancedMD Users | Tile Health