ID Medicare Chronic Care Revenue & APCM FAQ Guide

The AI system monitors lab schedules and automatically contacts patients who are overdue for viral load or ALT testing. By closing these gaps in care, the AI ensures the practice meets quality metrics while maintaining the continuous engagement required for chronic care reimbursement.

While the acute phase is different, post-treatment surveillance for patients with advanced fibrosis or cirrhosis qualifies for chronic care management. AI-driven outreach ensures these high-risk patients remain in the system for regular ultrasound and AFP screening, generating consistent revenue.

By using natural language processing, our AI call system engages patients in a conversational manner to identify barriers to care, such as transportation or pharmacy issues. This proactive approach keeps Hepatitis patients engaged in their treatment plan, which is critical for both health outcomes and billing continuity.

Long COVID management can be billed using CCM codes (99490, 99491) or complex CCM codes (99487) depending on the severity. AI tools assist by documenting the extensive time spent coordinating between specialists, such as cardiology and neurology, which is common in Long COVID cases.

Tile Healthcare's AI conducts regular, structured symptom assessments for Long COVID patients. This data is fed back to the ID specialist, allowing for data-driven adjustments to the care plan and providing the clinical documentation necessary to support high-level billing codes for complex care.

Yes, if the patient has two or more chronic conditions or a single complex condition expected to last at least 12 months, they may qualify. AI automation helps ID practices manage the intensive follow-up required for these patients, ensuring all clinical interactions are captured for reimbursement.

Yes, the AI performs automated adherence checks for antiretroviral and antiviral medications. It can identify patients at risk of non-compliance and escalate them to a clinical pharmacist or ID nurse, fulfilling the medication reconciliation requirements of Medicare's chronic care models.

Tile Healthcare utilizes end-to-end encryption and secure data protocols. The AI is programmed to verify patient identity before discussing sensitive information related to HIV or Hepatitis, ensuring that all communications meet the highest standards of HIPAA and patient privacy.

The AI scans your existing patient database to identify individuals with ICD-10 codes associated with HIV, chronic Hepatitis, and IACCI. It then flags these patients for the practice manager, streamlining the enrollment process and ensuring no revenue opportunities are missed.