NextGen APCM Enrollment & Workflow Checklist

Filter for patients with two or more chronic conditions using the PopHealth analytics dashboard to generate an initial lead list.

Ensure ICD-10 codes for chronic conditions are active and properly mapped to APCM-eligible categories within the patient's chart.

Run a batch eligibility check in NextGen PM to confirm Medicare or Medicare Advantage coverage for APCM G-codes.

Configure TileHealthcare AI to identify patients calling about chronic symptoms and flag them as potential APCM candidates in the EHR.

Use NextGen's risk scoring to prioritize high-utilization patients who would benefit most from chronic care management.

Modify the NextGen Care Management workflow templates to include required APCM documentation fields and time-tracking triggers.

Add APCM-specific codes like G0511 to the NextGen PM master file with the correct modifiers for specialty billing.

Create NextGen EHR tasking rules that notify care managers when a monthly 20-minute threshold is approaching for an enrolled patient.

Ensure TileHealthcare AI call transcripts and duration data sync directly into the NextGen EHR encounter for audit-proof documentation.

Configure NextGen Mobile to allow patients to upload remote monitoring data that supports the chronic care management plan.

Use AI voice agents to contact eligible patients, explain the APCM program benefits, and answer common questions about billing.

Record and transcribe patient verbal consent through TileHealthcare AI and automatically store the PDF in NextGen Document Management.

Automatically push the initial APCM care plan to the NextGen Patient Portal for patient review and digital signature.

Automate the scheduling of monthly 20-minute APCM check-in calls within the NextGen PM calendar to ensure billing compliance.

Use NextGen Report Writer to track the conversion rate of identified candidates to fully enrolled APCM patients.