Workflow GuideeClinicalWorks

eClinicalWorks APCM Patient Enrollment Guide

Step-by-step APCM enrollment workflow for eClinicalWorks practices. Optimize eCW patient registry and AI call handling for better care management.

Optimizing Advanced Primary Care Management (APCM) within eClinicalWorks requires a strategic approach to patient identification and enrollment. By leveraging eCW's internal Population Health tools alongside Tile Health's AI-driven outreach, practices can automate the high-volume task of patient consent and registry management while ensuring every step is documented for CMS compliance.

The Challenge

Many eClinicalWorks practices struggle with the manual effort required to identify eligible APCM patients and the administrative overhead of obtaining verbal consent, leading to underutilized care management modules and lost reimbursement revenue.

Step-by-Step Workflow

1

Identify Eligible Patients via eCW Registry

Utilize the eClinicalWorks Registry (HEDIS/CQM) or the Population Health module to filter your patient database for individuals with two or more chronic conditions. Export the list to identify the initial cohort for APCM enrollment.

Best Practices
  • Use the 'Registry' feature to filter by specific ICD-10 codes relevant to APCM.
  • Ensure the 'Active' status is checked to avoid reaching out to inactive patients.
Common Pitfalls
  • Failing to filter for patients who have had a face-to-face visit within the last 12 months.
2

Automate AI Enrollment Outreach

Import your eligible patient list into Tile Health's AI call center system. The AI initiates personalized calls to explain APCM benefits, utilizing practice-specific scripts that reference the patient's primary care provider in eCW.

Best Practices
  • Schedule AI calls during peak engagement hours (10 AM - 2 PM).
  • Include a mention of the eCW Patient Portal to encourage digital sign-ups.
Common Pitfalls
  • Using overly technical medical jargon that confuses patients during the automated call.
3

Capture and Document Verbal Consent

The AI captures verbal consent for APCM services and records the interaction. This data is then pushed back into eClinicalWorks, specifically updating the 'Social History' or 'Care Management' module to reflect the enrollment status.

Best Practices
  • Ensure the AI explicitly mentions the right to stop APCM services at any time.
  • Use the eCW API to automate the creation of a 'Consent Received' log entry.
Common Pitfalls
  • Neglecting to record the specific date and time of consent in the patient's electronic record.
4

Develop the Comprehensive Care Plan

Once enrolled, use eCW Custom Templates to build a comprehensive care plan. The AI can pre-populate certain patient-reported data gathered during the enrollment call directly into the eCW Progress Note.

Best Practices
  • Link the care plan to the eCW Patient Portal so the patient can view it instantly.
  • Use 'Smart Forms' within eCW to standardize care plan elements for APCM.
Common Pitfalls
  • Creating a generic care plan that does not address the patient's specific chronic conditions.
5

Configure APCM Billing Codes

Set up the eCW Billing module with the correct APCM CPT codes. Configure billing alerts to trigger once the AI logs the required monthly care management interactions within the system.

Best Practices
  • Map APCM codes to the 'Care Management' billable time tracker in eCW.
  • Verify that your FQHC/RHC status is correctly reflected if using G0511.
Common Pitfalls
  • Confusing standard CCM (99490) billing rules with the new APCM reimbursement structure.
6

Establish Recurring AI Monitoring

Transition enrolled patients into a recurring AI check-in workflow. Tile Health's AI monitors patient status monthly, logging the time spent in the eCW Care Management module to support monthly billing claims.

Best Practices
  • Set up automated alerts for providers if the AI detects a change in patient health status.
  • Review the eCW 'Time Tracking' report weekly to ensure all interactions are captured.
Common Pitfalls
  • Manually entering call logs which leads to data entry errors and missed billing minutes.

Expected Outcomes

1

Increased APCM enrollment rates through automated AI outreach and registry mining.

2

Significant reduction in manual administrative tasks for eCW front-desk and clinical staff.

3

Improved compliance with CMS documentation requirements through automated eCW logging.

4

Higher patient engagement and portal utilization via AI-driven reminders.

5

Optimized revenue cycle management for chronic care services within eClinicalWorks.

Frequently Asked Questions

While it works with most versions, eCW V11 or higher is recommended for better API integration and Population Health module functionality.

Tile Health utilizes eClinicalWorks' FHIR APIs and secure integration bridges to update patient records, progress notes, and care management modules in real-time.

Yes, Tile Health's AI supports multilingual outreach, which is essential for multi-specialty practices using eCW in diverse demographic areas.

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eClinicalWorks APCM Patient Enrollment Guide | Tile Health