Oracle Health APCM Revenue Growth Case Study
Learn how an Oracle Health (Cerner) practice used AI call automation and HealtheIntent to scale APCM revenue and streamline PowerChart workflows.
A large multi-facility outpatient group integrated within a major health system struggled to capture Advanced Primary Care Management (APCM) revenue due to complex Oracle Health (Cerner) workflows and fragmented patient data across the HealtheIntent population health platform.
The practice faced significant hurdles in identifying eligible APCM patients within the HealtheIntent platform. Manual documentation in PowerChart was inconsistent, leading to missed billing opportunities for the new APCM codes. Additionally, the transition from legacy Cerner to Oracle Health created uncertainty regarding multi-facility billing attribution, while high call volumes prevented staff from performing required care management outreach and documentation required for CMS compliance.
TileHealthcare implemented an AI-powered call handling solution integrated with Oracle Health APIs. The AI identified high-risk patients via HealtheIntent data, automated outreach calls to fulfill APCM contact requirements, and directly documented interactions into PowerChart using standardized templates. This ensured all care management minutes were captured and accurately attributed to the correct facility for billing, bypassing the manual data entry bottleneck.
How They Rolled It Out
HealtheIntent Data Mapping
Connected the AI platform to HealtheIntent to pull real-time risk scores and chronic condition data for automated patient stratification and APCM eligibility.
PowerChart Template Standardization
Developed specific APCM documentation templates within Cerner PowerChart to ensure all CMS compliance elements were met automatically by the AI during call logging.
API Integration for Multi-Facility Billing
Configured Oracle Health APIs to route APCM billing codes to the appropriate facility NPI based on the patient's primary care location within the health system.
AI-Driven Outreach Deployment
Launched automated voice agents to handle monthly check-ins, medication reconciliation prompts, and care plan updates required for APCM reimbursement.
The Results
“Integrating TileHealthcare with our Oracle Health environment transformed our APCM program. Before, our staff was buried in PowerChart clicks; now, the AI handles the documentation and outreach, allowing us to capture revenue we didn't even know we were losing while keeping our patients healthier.”
Frequently Asked Questions
The AI uses secure API integrations to write structured notes directly into the PowerChart Message Center or Clinical Notes section, following your specific APCM templates.
Yes, the system is configured to identify outpatient encounters specifically, ensuring APCM billing is not triggered by inpatient stays, maintaining compliance with CMS regulations.
No, the AI leverages your existing HealtheIntent data feeds to identify patients; we provide the bridge between that population health data and actionable outreach.
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