CareSync had a four-year head start creating a coordinated care solution that eventually fit CPT Code 99490, as well as leadership that was truly focused on patient-centered care from the very beginning. These facts have set CareSync apart in the industry. In this article, Amy Gleason, RN, and Chief Operating Officer of CareSync™, describes other ways CareSync has been able to differentiate its Chronic Care Management (CCM) services.
When you ask someone at CareSync what makes our CCM services different, we’re inclined to answer, “Everything.” But we’re biased. So for the purposes of this blog, I’ll focus on seven differentiators.
1. Our People
First and foremost, I’d say our people. I won’t even try to explain how much they truly care about the patients, or the physicians we support, or even each other. Suffice it to say, we’ve been blessed in finding really great people who have created a culture of care, respect, and cooperation that rivals any I’ve seen. I have a real sense of pride coming to work and seeing them in action.
2. Our Collaborative Approach
Second, I’d say our approach to the requirements. We tend to take a more comprehensive view that we believe is conservative in compliance and aggressive in meeting the spirit of the code.
For example, the average Medicare patient sees seven providers, but we don’t work with just the one provider who enrolls the patient in the program. We also work with the other six providers to make sure their directives are included. We believe the only way to truly coordinate care and create a single, comprehensive Care Plan is to include the entire scope of a patient’s medical records.
3. Personalized Care
Third, CCM is a very labor intensive process. Many competitors use canned plans and just apply them to different health conditions. CareSync takes the time to personalize our care. We focus on a patient’s specific health challenges, creating individualized plans using the records of the primary provider and the specialists who see the patient.
We reinforce the plans the providers have created and consolidate the records into one complete Care Plan that is comprehensive, yet easy for the patient to follow. We’ll also work to resolve any conflicting information that might have the patient or family confused.
4. We Remove Barriers
Fourth, we attempt to remove any barriers that are keeping the patient from accomplishing the goals of their Care Plan. For example, if the patient is missing doctor appointments, we find out why. Is it because they need a ride? If so, we’ll identify resources to overcome that. If they aren’t taking their medication, is it because they have a side effect they don’t like or is it a cost issue? We’ll work to resolve that.
5. Time For Patients
Fifth, with a staff of over 300, we have the resources to spend time with patients. The requirements list 20 minutes of care coordination as a minimum for 99490. We frequently find it takes more time, especially when the patient is first enrolled and we are gathering medical records and building their personalized Care Plan.
CMS acknowledged they used the 20-minute minimum as a threshold; they know it will take more time than that to work toward all of the requirements each and every month. That's one of the reasons they expanded the program in 2017 with new codes and greater reimbursement for complex cases.
At CareSync, we spend the time necessary to ensure the patient has what they need. And regardless of the time spent coordinating care for the patient, we charge the practice a flat fee for our services.
Sixth, our experience and knowledge allows us to overcome challenges quickly. For example, one of the operational challenges practices face when implementing CCM is navigating the way different insurance plans pay different amounts. Details like that can make it difficult to know which patients to enroll in the service and how to set expectations regarding copays for the patient.
We’ve had experience with all types of plans and billing situations. We know what works and what doesn’t and can guide you in the right direction.
Seventh, we minimize disruption to workflow. When you work with CareSync, you get the benefit of leveraging the best practices we’ve developed from implementing CCM throughout the country.
Each account has a designated account manager as a single point of contact. The account manager guides them through each step of the process.
Our implementation team works with the practice to educate them about compliance. Some providers aren’t always sure what to provide and when. We can help. We can identify ways to optimize workflows and determine the best mix of methodologies that will work for the client to make enrolling patients as efficient and effective as possible.
And, something our clients truly appreciate, we have billing specialists on our team who can guide practices through the billing process and answer questions about billing under the code.