Workflow GuideeClinicalWorks

eClinicalWorks APCM Chronic Care Monthly Check-In Workflow

Optimize your eClinicalWorks APCM workflow with AI-powered monthly check-ins. Improve eCW documentation, billing, and patient engagement for chronic care.

Implementing a monthly check-in workflow for Advanced Primary Care Management (APCM) in eClinicalWorks requires a seamless blend of automated outreach and precise clinical documentation. By leveraging Tile Health’s AI-driven call solutions, eCW practices can automate the 20-minute monthly requirement, ensuring every interaction is logged directly into the Care Management module while maintainin...

The Challenge

Many eClinicalWorks practices struggle with the manual overhead of tracking non-face-to-face time, leading to underutilized Care Management modules and missed APCM revenue. Manual phone tag and fragmented documentation in eCW often result in billing gaps and inconsistent patient monitoring.

Step-by-Step Workflow

Identify Eligible Patients in eCW Registry

Utilize the eClinicalWorks Registry or Population Health (HEDIS) dashboard to filter patients with two or more chronic conditions eligible for APCM. Export this list or use the API to sync with your outreach tool.

Best Practices

Set up custom registry filters specifically for APCM eligibility
Verify patient consent is documented in the eCW 'Social History' or 'Care Management' tab

Common Pitfalls

Failing to filter by active insurance types that support APCM codes

Configure AI-Powered Outreach Trigger

Set up Tile Health to trigger automated monthly check-in calls based on the eCW patient schedule or the last documented care management encounter date.

Best Practices

Align outreach dates with the patient's existing eCW appointment cycle
Use the eCW Patient Portal to notify patients of upcoming AI check-ins

Common Pitfalls

Overlapping AI calls with existing staff-led telephonic encounters

Conduct Structured AI Check-In

The AI handles the initial screening, asking about medication adherence, new symptoms, and ER visits using templates that mirror your eCW clinical documentation requirements.

Best Practices

Mirror your eCW SmartForms in the AI script logic
Include specific questions about medication changes since the last eCW update

Common Pitfalls

Using generic scripts that do not capture the data points required for eCW billing

Automated Documentation Sync to eCW

Automatically push the AI call transcript and a structured summary into the eCW 'Care Management' or 'Progress Notes' section using secure API integration.

Best Practices

Route summaries to the 'Telephone Encounters' folder for provider review
Ensure the AI logs the start and end time for audit-proof records

Common Pitfalls

Manually copy-pasting notes from external tools into eCW

Time Tracking and Billing Integration

Ensure the total AI call duration is accurately logged under the specific APCM CPT codes (e.g., G0511) within the eCW billing module or 'Encounters' screen.

Best Practices

Use eCW 'Billing Alerts' to flag patients who have met their 20-minute monthly threshold
Link the AI interaction time directly to the APCM encounter code

Common Pitfalls

Under-reporting non-face-to-face time due to poor documentation of call duration

Task Escalation via eCW T-Actions

Program the AI to identify high-risk responses and automatically trigger a T-Action or Telephone Encounter in eCW for immediate clinical intervention by a nurse or provider.

Best Practices

Set up priority levels for T-Actions based on AI sentiment analysis
Assign these tasks to the specific Care Coordinator listed in eCW

Common Pitfalls

Failing to define clear escalation triggers for the AI

Monthly Billing Review in Claim Analysis

Use the eCW Claim Analysis tool to verify that all documented AI interactions meet the required time and clinical criteria before final submission to CMS.

Best Practices

Run a monthly report on 'Unbilled Care Management Time' within eCW
Cross-reference AI logs with eCW encounter statuses

Common Pitfalls

Submitting claims without verifying the documented time in the Care Management module

Expected Outcomes

Increased APCM enrollment by automating initial outreach and screening

100% accurate time-tracking within the eCW billing module for audit compliance

Significant reduction in administrative burden on clinical staff

Improved patient medication adherence through consistent monthly touchpoints

Higher capture rate for G-series billing codes and improved practice revenue

Frequently Asked Questions

Tile Health utilizes eCW’s open APIs and FHIR standards to push call logs, transcripts, and structured clinical data directly into the patient's Care Management record or Progress Notes.

Yes, our AI is fully customizable and can be programmed to follow your specific eCW templates, SmartForms, and documentation workflows to ensure clinical consistency.

Absolutely. All time spent by the AI interacting with the patient is logged as non-face-to-face care management time, directly supporting the documentation required for CMS billing.

If a patient reports a red-flag symptom, the AI immediately triggers a priority Telephone Encounter (T-Action) in eCW and can be configured to transfer the call to a live staff member.

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