MEDITECH Medicare Chronic Care Revenue FAQ | Tile Healthcare

Older versions often lack integrated time-tracking for chronic care. This leads to under-billing or 'lost' minutes. By using an AI-driven call center that interfaces with MEDITECH 6.x, you can capture every billable interaction that usually goes unrecorded on paper logs or disparate spreadsheets.

Yes. In MEDITECH environments where the hospital owns the practice, capturing the 'Pro-Fee' is vital. The AI system identifies the specific attending physician assigned in MEDITECH and ensures the APCM claim is generated under their NPI, maximizing the revenue for the professional group.

MEDITECH’s Population Health module can pull data on chronic conditions (ICD-10 codes). Our AI enhances this by identifying gaps in care during calls—such as missed screenings—and feeding that data back into MEDITECH, which helps in meeting the quality metrics required for full APCM reimbursement.

The AI uses natural language processing to understand the patient's update. If it's a routine status change, it updates the MEDITECH chart. If the AI detects a 'red flag' symptom, it immediately routes the call to a live nurse and creates an urgent message in the MEDITECH task queue.

Tile Healthcare’s AI has read/write access to MEDITECH Community Wide Scheduling (CWS). If a chronic care patient needs a follow-up during an APCM call, the AI can check for available slots and book the appointment directly, closing the loop on care management.

During the APCM call, the AI can review the medication list pulled from the MEDITECH Pharmacy (PHA) module. It asks the patient if they are adherent and if they need refills, then generates a report for the provider to review and sign off within the MEDITECH workflow.

CAHs often serve high-risk populations with multiple comorbidities. Using AI to manage APCM within MEDITECH allows these hospitals to create a sustainable revenue stream that offsets the costs of rural care while providing the intensive monitoring these patients require.

CMS requires proof of 20 minutes of care, a comprehensive care plan, and patient consent. Our AI ensures these three pillars are documented in MEDITECH. Every call transcript and duration log is stored as a clinical note, making audit responses simple and data-driven.

Using a certified EHR like MEDITECH Expanse is a prerequisite for APCM billing. Our AI call center is designed to complement MEDITECH's certified features, ensuring that the data captured during phone interactions meets the 'structured data' requirements for CMS EHR incentive programs.