Medicare Chronic Care Revenue Guide for Orthopedics

Our AI screening tools scan your patient panel for Medicare beneficiaries with a diagnosis of osteoporosis and at least one other chronic condition, flagging them for enrollment in bone density management and fall prevention programs that qualify for CCM revenue.

Yes, chronic back pain associated with spinal stenosis or degenerative changes is a qualifying condition. Managing these patients through AI-driven check-ins ensures they stay compliant with home exercises and medication, which justifies the monthly care coordination fee.

Once the global surgical period ends, patients with remaining chronic issues or comorbidities can be transitioned into a chronic care program to monitor long-term joint health, functional mobility, and physical therapy compliance while generating monthly revenue.

Yes, the AI can perform standardized fall risk assessments during monthly calls, documenting gait stability and home environment safety. These are critical components of orthopedic chronic care plans and are recorded directly into the patient's record.

Our AI call center generates structured clinical notes and time logs that sync directly with your EHR, providing the necessary audit trail for APCM and CCM codes without requiring manual data entry by your clinical or administrative staff.

Certainly. If a patient reports increased joint swelling, severe pain, or a fall during an automated check-in, the system immediately alerts your clinical team for urgent intervention, ensuring high-quality care alongside revenue generation.

TileHealthcare operates on a performance-based model that avoids heavy upfront costs, allowing orthopedic practices to become cash-flow positive within the first 60 to 90 days of enrolling their Medicare panel into the program.

By automating the routine monthly check-ins, your medical assistants can focus on in-office surgical prep and patient flow, while the AI manages the high-volume outreach required for chronic care billing compliance.

In fact, better chronic care management improves outcomes and reduces readmissions, which helps your practice perform better under bundled payment models and value-based care contracts by providing continuous monitoring after the acute episode.