For practices without the resources to meet the billing requirements for chronic care management (CCM), another option is available for obtaining at least some of code’s clinical and financial benefits: outsourcing the work to a third party. That’s what Pankaj Desai, MD, FACP, and his partner in a suburban Baltimore internal medicine practice did when they decided to start billing for CCM services in March 2017.
Between them, the two providers had about 400 Medicare patients with multiple chronic conditions, but the practice lacked the staffing resources to meet the CCM requirements for even a fraction of that number. So after Desai and his partner enroll a patient in a program and develop a care plan, they turn over the follow-up contact work to CareOne Team, based in Rock Hill, South Carolina.
“They have access to our EHR, so every month they put in notes saying how much time they spent talking to each patient, what was discussed, and so forth,” Desai explains. “We review the information and sign off on it before submitting it to Medicare for payment.”
But while Desai and his partner now are able to provide CCM services, outsourcing the follow-up contacts with patients does come with drawbacks—starting with the cost. CareOne Team takes 65% of the revenues the practice gets from billing CCM.
Another problem is patient response. “The feedback we’ve gotten from a lot of patients is that they don’t know who’s calling them and we have to explain it’s someone working for us,” Desai says.