Osteoporosis Chronic Care Revenue & AI FAQ Guide

Maximize Medicare revenue for Osteoporosis with AI automation. Learn about APCM, DEXA scheduling, and fall prevention workflows for your practice.

Optimizing Medicare revenue for osteoporosis care requires meticulous monitoring of bisphosphonate therapy, DEXA scheduling, and fall risk assessments. Tile's AI-powered call center solutions automate patient outreach and documentation, ensuring your practice captures APCM reimbursements while improving secondary fracture prevention outcomes and patient adherence.

APCM & Billing Optimization

5 questions

Tile's AI automates the monthly 20-minute clinical staff time requirement for Advanced Primary Care Management (APCM). By handling routine check-ins regarding medication side effects, lifestyle modifications, and bone density follow-ups, the system logs every interaction, providing the necessary documentation for Medicare reimbursement.

Yes, our AI integrates with your EHR to identify Medicare patients with a diagnosis of osteoporosis or a history of fragility fractures. It then initiates outreach to enroll them in chronic care management or APCM programs, ensuring no eligible patient—and no potential revenue—is overlooked.

Absolutely. The AI specifically tracks and documents quality measures such as 'Osteoporosis Management in Women Who Had a Fracture' (Measure #39) and 'Falls: Screening for Future Fall Risk' (Measure #154), ensuring your practice meets the requirements for maximum Medicare incentive payments.

The ROI is generated through two main channels: increased billable APCM/CCM minutes without adding staff, and a significant reduction in missed DEXA scan appointments. By automating the high-volume, low-complexity calls, your clinical staff can focus on high-risk patients while the AI maintains the revenue-generating baseline.

Medication adherence checks for drugs like bisphosphonates are billed as part of the monthly chronic care management cycle. Tile's AI performs these checks, documenting patient compliance and any reported gastrointestinal issues, which counts toward the required clinical interaction time.

APCM & Billing Optimization

How does AI help capture APCM revenue for osteoporosis patients?

Can AI identify patients eligible for osteoporosis chronic care programs?

Does the AI support documentation for MIPS quality measures?

What is the ROI of using AI for osteoporosis care management?

How are medication adherence checks billed under Medicare?

Clinical Workflow Automation

How does Tile manage denosumab (Prolia) injection tracking?

Denosumab requires strict six-month dosing intervals. Tile's AI automatically calls patients one month prior to their window to schedule the injection and follows up if they miss the appointment, preventing the rapid bone loss associated with delayed denosumab therapy.

Can the AI handle DEXA scan scheduling and follow-up?

Yes. The AI monitors the two-year Medicare coverage window for DEXA scans. It proactively contacts patients when they are eligible for a repeat scan, explains the importance of T-score monitoring, and interfaces with your scheduling system to book the appointment.

How are fall risk assessments integrated into the AI calls?

During routine chronic care calls, the AI conducts standardized fall risk screenings. If a patient reports a recent fall or increased instability, the AI immediately flags the record for a provider review and suggests a home safety evaluation, meeting Medicare's fall prevention quality standards.

What happens if a patient reports side effects from bisphosphonates?

If a patient mentions symptoms like heartburn or jaw pain during an AI interaction, the system uses natural language processing to categorize the severity and immediately routes the transcript to your clinical team for urgent intervention, ensuring patient safety and treatment continuity.

Does the AI support secondary fracture prevention programs?

Tile supports Fracture Liaison Service (FLS) models by automating the 30, 60, and 90-day post-fracture follow-ups. It ensures patients have started their pharmacotherapy, completed their DEXA, and are attending physical therapy, which are critical steps for preventing secondary fractures.

Patient Education & Safety

How does the AI handle calcium and Vitamin D counseling?

The AI provides consistent, evidence-based reminders regarding daily calcium and Vitamin D intake. It can answer common patient questions about supplement types and timing, ensuring patients follow the NOF guidelines between office visits.

Can the AI provide guidance on weight-bearing exercises?

Yes, as part of a structured care plan, the AI encourages patients to engage in weight-bearing and resistance exercises. It can provide verbal cues for simple balance exercises and track the patient's self-reported activity levels for your records.

Is the AI capable of explaining DEXA results to patients?

While the AI does not diagnose, it can be programmed to share T-score results after a provider has reviewed them, explaining the difference between osteopenia and osteoporosis and reinforcing the importance of the prescribed treatment plan.

How does the AI improve patient adherence to oral bisphosphonates?

The AI reinforces complex administration instructions—such as taking the pill on an empty stomach and remaining upright for 30 minutes. Regular automated check-ins confirm the patient is following these steps, which significantly reduces discontinuation rates due to preventable side effects.

How does the system handle home safety evaluations?

The AI can walk patients through a home safety checklist, asking about trip hazards like throw rugs or poor lighting. The responses are compiled into a report for the provider to review during the next Annual Wellness Visit or chronic care check-in.

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Osteoporosis Chronic Care Revenue & AI FAQ Guide

APCM & Billing Optimization

Clinical Workflow Automation

Patient Education & Safety

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