16 Topics to Consider When Choosing A CCM Vendor
Choosing a CCM vendor can be overwhelming and difficult. To ensure that you make an educated decision, ChartSpan recommends asking your potential CCM vendor a series of important questions categorized by 16 topics.
• Who is the primary customer in the Chronic Care Management (CCM) program? (The answer should always be the patient.)
• How will you integrate with my EHR?
• Can you accommodate the bi-directional exchange of patient clinical data and care plans, in and out of our EHR?
• What kind of access privileges to our EHR will we need to give to your team?
• Explain the process you’ll use to extract our EMR demographic reports to identify eligible CCM patients.
• As my CCM vendor, will you automate a billing feed for my Biller so we don’t have to manually bill each transaction?
• How often will we be able to bill CCM claims? Monthly, weekly, realtime?
• What costs will you cover to integrate with my EHR?
• How many times have you integrated with my EHR vendor?
• What do you expect of the practice for training and onboarding?
• Which staff members are required to participate in training?
• Will training/support be on-going after our initial launch?
• Explain the process you will utilize to consent our patients.
• What are your average patient enrollment conversion rates in the first 30, 90 and 180 days of onboarding a new client?
• What percentage of patients do you expect to enroll in CCM?
• How do you ensure exact and accurate communication of copay information to patients during the enrollment process?
• What is your strategy to communicate with our patients prior to enrollment ensuring they know your call is a partnership with our practice and providers?
• Will you call our patients from a ChartSpan number or a local area code similar to ours?
• What, if any, materials or welcome packets are sent to the patient after they enroll explaining the program?
• How often do you follow up with a patient in an effort to enroll them? When do you stop?
• What steps can be taken to correct inaccurate data in our demographic reports so every eligible patient can be contacted?
• Are all patient enrollment and clinical calls recorded, archived and available for our review?
• What are your inbound telephony service level metrics (time to answer inbound patient calls, average amount callers spend on hold, average time to return a voicemail and call abandonment rate?)
• Upon request, how long will it take for you to send us a recorded patient call?
• How many focus groups have you done with seniors to validate their understanding of a care coordination service and what they value most?
• Are you willing to share the results with us?
• How do you measure patient satisfaction and how will that information be shared with us?
• How many patients unenroll monthly from your program by practice?
• How do you train your new clinical staff and how much time is spent in ongoing training for your existing clinical staff?
• How many weeks do your clinicians go through floor shadowing during their initial training before being allowed to interact with patients?
• What are the specific personality traits you have found that make the most effective clinician for this program?
• How many hours did your clinical staff spend in training last month?
• Who heads up your clinical training program and what is their depth of experience?
• Can you walk me through your Quality Assurance program and process?
• How often is each clinician’s performance reviewed?
• How often does your QA team audit each of your clinicians?
• Will you provide your QA audit form with us?
• What are the coaching sessions like between your QA team and clinicians?
• Do you review every call and chart, either with a human being or artificial intelligence software?
• Can we see your rubric scoring sheet?
• In your proforma you provided does it factor traditional patient churn rates, copay patient collection rates, deceased rates, and various payer mixes?
• As my CCM vendor, do you have data that shows the potential impact your CCM program will have on my overall Fee For Service?
• We know that patient deductibles reset in January each year. How do you counsel your clients to manage copay billings during deductible season?
• What steps are taken when a patient asks to unenroll due to deductible costs?
• Do you have a full-time pharmacy team that handles daily medication refill requests?
• Will you alter your CCM medication workflow to accommodate the unique needs of our practice?
• Do you have a free prescription drug savings card that is available for every CCM patient?
• Tell us about your 24/7 nurse triage line.
• What level of clinician operates this and what protocols do they follow?
• Do you use industry standard protocols such as Schmitt-Thompson?
• What are your guaranteed service level metrics for the hotline?
• Can we see a copy of your required Comprehensive Care Plan or Patient Health Summary for a typical patient?
• Besides the per patient CCM fee, have you ever charged a customer any other type of fee?
• Will you charge us any upfront fees?
• Will you cover any potential EHR fees?
• What is your policy if I get a denial for services? Am I still charged?
• Can you demonstrate your CCM software?
• Did you build your software or purchase it?
• Please explain your security and encryption technologies.
• Is your software ONC certified?
• How often do you make changes or improvements to your software and process?
• Do you intend to help us with our MIPS and other quality scores while administering our CCM program?
• Is there any additional cost for your MIPS/quality services?
• Can you explain how CCM supports Value-Based Care Models and how it may increase my participation with my ACO or APM?
• How did your MIPS performance reporting compare to the 2018 national averages.
• Is your system set up to help me with my ACO requirements? HCC scoring? Beneficiary Attribution? Annual Wellness Visits?

Are you ready to run a successful program?
Schedule a call with an expert to see how we can help increase revenue, expedite reimbursements, deliver valuable support and improve patient outcomes.
Schedule a call with an expert to see how we can help increase revenue, expedite reimbursements, deliver valuable support and improve patient outcomes.
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