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KNOWING your patients are following your care plan

Introducing Chronic Care Management Services

Extend care beyond your office setting to effectively manage Medicare patients with multiple chronic conditions. Quest Chronic Care Management (CCM) Services are designed to help you minimize disruptions, save staff time, comply with Centers for Medicare & Medicaid Services (CMS) reimbursement requirements, and improve health outcomes.

With Quest CCM Services, your practice benefits from:

  • Chronic care expertise to extend care beyond your office
  • Robust tools to help you meet CCM care goals and comply with CMS reimbursement requirements
  • A comprehensive program that handles administrative tasks
3 out of 4 Americans over 65 suffer from multiple chronic conditions
75% of primary care visits are for patients with chronic conditions
Expertise to extend care

Expertise to extend care

Medicare patients with multiple chronic conditions will be assigned dedicated care coordinators, all managed by a registered nurse. Our coordinators, many of whom are nurses, understand patient needs and work under your general supervision and direction.

Some of the services provided include:

  • Development of comprehensive care plans that will be approved by practice physician(s)
  • Medication reconciliation to support patient compliance
  • Notifying physician if patient reports an ER visit, hospital discharge, or skilled nursing facility stay
  • Coordination with specialists and home-based providers
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Tools to meet financial goals

Tools to meet financial goals

Quest CCM Services can help you better manage patients with multiple chronic conditions and control costs by potentially reducing unnecessary office visits, ER visits, and hospital readmissions—a key goal for hospital staff.

Our services can help you comply with CMS requirements:

  • Every encounter is properly tracked
  • Receive a monthly report that documents the provision of 20 minutes of non-face-to-face patient management per patient (CPT 99490*)
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A comprehensive program

A comprehensive program

Quest CCM Services can help you save staff time by handling administrative tasks and providing you with easy-to-use technology that integrates with your existing workflow.

The CCM Services platform:

  • Includes user-friendly provider reports
  • Aggregates clinical and patient information to create a holistic perspective of the patient’s care to date
  • Can connect to a provider’s EHR, allowing the CCM care team to review necessary patient care information
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A customized experience, for continuity of care

Quest CCM Services provide you and your patients with a customized experience based on specific needs. Our care coordinators build relationships with each patient—to keep them motivated and ensure continuity of care.

Other services include:

    • Monthly patient mailings and engagement materials, including resources available through Healthwise®—to help educate patients and reinforce adherence
    • Bilingual and translation services—to help ensure clear communication and patients' participation in managing their health
    • Coordination and access to community resources, including transportation and meals—to help meet diverse patient needs
A customized experience, for continuity of care

Quest CCM participation requirements and expectations

Participating physician practices must:

  • Record patient information in certified EHR technology
  • Offer 24/7 urgent care support or on-call services, with access to the patient’s records
  • Stay engaged by overseeing the creation of and updates to a care plan
  • Be willing to work with care coordinators to ensure the care plan is clinically integrated or aligned with the overall treatment plan for the patient
References:
  1. Centers for Disease Control and Prevention. Multiple chronic conditions. Available at www.cdc.gov/chronicdisease/about/multiple-chronic.htm. Accessed June 1, 2017.
  2. Zamosky L. Chronic disease: a growing challenge for PCPs. 9 Aug 2013. Available at medicaleconomics.modernmedicine.com/medical-economics/content/tags/chronic-disease/chronic-disease-growing-challenge-pcps. Accessed June 1, 2017.

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.