Question 1

How do we identify APCM-eligible patients within Epic?

Accepted Answer

We utilize Epic’s Reporting Workbench and Registry Framework to pull patients meeting CMS criteria. Our AI integration scans these registries in real-time, identifying those with two or more chronic conditions and high-risk scores, ensuring your outreach list is always current without manual data entry.

Question 2

Can AI automate the enrollment status in the Epic Registry?

Accepted Answer

Yes. When our AI call center successfully enrolls a patient, it triggers an API call to update the 'CCM Enrollment Status' field within the Epic patient header or registry. This prevents manual status updates and ensures your clinical staff sees the most up-to-date enrollment data.

Question 3

How does the system handle Epic's Healthy Planet risk stratification?

Accepted Answer

Our automation leverages Healthy Planet risk scores to prioritize outreach. Patients with rising risk scores in Epic are automatically flagged for more frequent touchpoints, allowing your team to focus on high-acuity patients while the AI manages routine APCM check-ins.

Question 4

Can we filter outreach based on MyChart activation?

Accepted Answer

Absolutely. We can segment your Epic patient list by MyChart status. For active users, we can coordinate AI calls with MyChart secure messages. For inactive users, the AI focuses on phone-based engagement and can even offer to send a MyChart activation link via SMS.

Question 5

How are AI-driven phone calls documented in Epic?

Accepted Answer

Every AI interaction is transcribed and pushed directly into Epic as a Telephone Encounter or a specific CCM Note. This ensures that the time spent on the call is captured for audit purposes and that the clinical team has a full record of the patient conversation.

Question 6

Does the AI coordinate with Epic's MyChart messaging?

Accepted Answer

Yes, our platform acts as an extension of MyChart. If a patient is unreachable by phone, the system can automatically trigger a MyChart message. Conversely, if a patient asks a question via MyChart, the AI can follow up via phone to provide more detailed APCM support.

Question 7

How is patient consent for APCM captured in Epic?

Accepted Answer

During the automated enrollment call, the AI follows a script to obtain verbal consent. This consent is recorded, time-stamped, and automatically uploaded to the 'Media Manager' or documented in the 'Consent' section of the Epic chart, satisfying CMS documentation requirements.

Question 8

Can the AI schedule follow-up appointments directly in Epic?

Accepted Answer

Yes. Using Epic’s Cadence or App Orchard APIs, the AI can identify open slots in the provider's schedule and book follow-up appointments for APCM patients who require an in-person visit, seamlessly updating the Epic schedule in real-time.

Question 9

How does automation assist with Epic Care Plan documentation?

Accepted Answer

Our AI extracts key data points from patient calls—such as changes in symptoms or medication adherence—and maps them directly to the 'Care Plan' activity in Epic. This reduces the time clinicians spend on manual data entry while ensuring the care plan remains a living document.

Question 10

Can we use Epic SmartPhrases with automated APCM notes?

Accepted Answer

Yes. Our system is designed to populate Epic notes using your organization's existing SmartPhrases and templates. This ensures that the AI-generated documentation maintains the same 'look and feel' as your internal clinical notes, improving readability for your providers.

Question 11

How is the 20-minute APCM time requirement tracked in Epic?

Accepted Answer

Every second the AI spends interacting with the patient or processing their data is logged. This time is aggregated and pushed to Epic’s 'Time Capture' or 'Charge Capture' modules, ensuring you have a defensible audit trail for every minute billed under APCM codes.

Question 12

Does the system update the Epic Problem List?

Accepted Answer

While the AI does not delete problems, it can flag potential new conditions or updates based on patient responses. These are presented to the clinician as a 'Pending' update in the Epic encounter, allowing the provider to review and finalize the Problem List with one click.

Question 13

How does the solution integrate with Epic Resolute billing?

Accepted Answer

Once the monthly APCM requirements are met, our system can trigger a 'Charge Trigger' in Epic Resolute. This automates the submission of G0511 or other relevant APCM codes, significantly reducing the administrative burden on your billing department.

Question 14

Can automation identify 'missing' APCM billing opportunities in Epic?

Accepted Answer

Yes. By cross-referencing Epic’s billing data with registry activity, our AI identifies patients who received APCM services but haven't had a claim generated. This ensures no revenue is left on the table due to documentation gaps or coding errors.

Question 15

How are Epic upgrade cycles managed with this integration?

Accepted Answer

We maintain a dedicated integration team that monitors Epic’s quarterly upgrade cycles. We test our API connections in your 'TST' or 'REL' environments before the upgrade hits 'PRD,' ensuring your APCM workflows are never interrupted by software version changes.

Question 16

Does the AI support Epic’s Community Connect sites?

Accepted Answer

Yes. Our solution is scalable across Community Connect environments, allowing a central health system to provide automated APCM services to its affiliate practices while maintaining data isolation and custom workflows for each specific site.

Epic EHR CCM Automation FAQ: Scale APCM Workflows

Epic Registry & Patient Identification

MyChart & Digital Outreach Coordination

Clinical Documentation & Care Planning

APCM Billing & Compliance in Epic

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