Chronic Care Management (CCM) Provider Checklist - 2024
This resource is intended to assist home based medical care providers with effectively managing Chronic Care Management (CCM) services, inclusive of guidance on how to identify eligible patients with multiple chronic conditions, initiate appropriate visits for assessment and consent, document patient consent, record and update patient information in certified Electronic Health Record (EHR) systems, develop
Patient Qualifications Durable Medical Equipment - Home Oxygen - 2024
This resource was created to provide clarity around the patient qualifications and provider documentation requirements for home oxygen equipment.
Home-Based Medical Care: Telehealth Guidelines & Coding Requirements - 2024
A comprehensive resource designed to provide guidance to home-based medical care programs in the use of telehealth services to care for their patients with the expansion of reimbursement opportunities post-pandemic. All content reflects 2024 updates and was gathered utilizing Centers for Medicare & Medicaid Services (CMS) guidelines.
Suggested Equipment and Supplies for HBPC - 2024
This resource list the recommended supplies that providers should carry each day in order to effectively perform procedures and provide quality care to patient each day.
Gastrostomy Tube Replacement Procedure for Home-Based Medical Care Providers - 2024
This resource is intended for home-based primary care (HBPC) providers and practice staff to provide procedure recommendations for replacement of gastrostomy tube in the home setting.
Knee Aspiration & Injection Procedure for Home-Based Medical Care Providers - 2024
This resource is intended for home-based primary care (HBPC) providers and practice staff to describe step-by-step instructions for performing knee aspirations and injections in the home setting.
Tracheostomy Tube Replacement Procedure for HBPC Providers - 2024
This resource is intended for home-based primary care (HBPC) providers and practice staff to provide procedure recommendations for replacement of tracheostomy tube in the home setting.
Annual Wellness Visit Template Guidelines - 2024
This resource is intended for home-based primary care (HBPC) providers and practice staff and assists with the creation of a template for annual wellness visits (AWV) by providing the required documentation elements necessary to bill for this service; however, be sure to review the Centers for Medicare & Medicaid Services (CMS) guidelines for a full
Provider Orders and Instructions Form - 2024
The Provider Orders/Instructions Form is a comprehensive document designed to convey clear and precise healthcare directives from a physician to the patient and other healthcare professionals involved in the patient's care. This form serves as a written record of the physician's recommendations, treatment plans, and specific instructions to ensure accurate and consistent implementation across the
Durable Medical Equipment: Wheelchairs, Power Mobility Devices, and Hospital Beds - 2024
This resource was created to provide clarity around the patient qualifications and provider documentation requirements for standard wheelchairs, power mobility devices and hospital beds. The content was gathered from various Centers for Medicare & Medicaid Services (CMS) sources.
Infection Control Guidelines - 2024
This resource is intended for home-based primary care (HBPC) providers and practice staff and provides an overview of infection control.
Chronic Care Management (CCM) Care Plan Requirements - 2024
This resource is intended for home-based primary care (HBPC) providers and practice staff and provides an overview of the 2024 required elements for the Chronic Care Management (CCM) Care Plan. This resource may be utilized as a guide to create a standard CCM Care Plan but is not all-inclusive. Refer to CMS guidelines for full
Home Based Medical Care Practice Intake Guide - 2024
This resource is a communication guide for staff who conduct intake calls and/or respond to calls from patients and/or caregivers interested in enrolling in a home-based primary care practice.
Professional Resources for the Homebound Patient - 2024
Assist patients and caregivers with identifying local specialty providers, services, and resources to support with the interdisciplinary care of frail, medically complex, and chronically ill homebound patients.
Home-Based Medical Care: Superbill Worksheet - 2024
A comprehensive list of the primary services that a home-based medical care practice would bill and submit for reimbursement. Includes CPT® codes, location of service (if applicable), service descriptor, 2024 wRVU, 2024 Medicare National Fee Schedule Payment, and precalculated 85% of Medicare allowable payment (NP/PA). This information allows programs to estimate revenue, create an internal
Home Based Medical Care Advanced Coding Opportunities - 2024
A comprehensive resource to assist home-based medical care providers and practice staff with understanding the advanced coding opportunities beyond Evaluation and Management (E/M) Current Procedural Terminology (CPT®) codes that are available billing and reimbursement based on the high level of complexity of patient needs. These 2024 CPT codes align with the care provided and allow
Home-Based Medical Care Evaluation and Management (E/M) Guidelines - 2024
This resource is intended to serve as a reference for home-based providers that review the Evaluation and Management (E/M) documentation & coding guidelines on the criteria needed to support billing for the different levels of service for the home visit CPT range (CPT 99341-99350). Refer to CMS guidelines1 for full details and requirements.
Social Determinants of Health (SDoH) Screening and Coding Requirements - 2024
This resource is intended to provide home based medical care providers and practice staff an overview of the basic understanding of Social Determinants of Health (SDOH), its impact in patient care and medical decision making, and the importance of documentation in the SDOH Risk Assessment. All content reflects 2024 Centers for Medicare & Medicaid Services
Risk Adjustment Factors (RAF) for House Calls: Hierarchical Condition Categories (HCC) Coding Guide - 2024
Hierarchical Condition Category (HCC) Coding is the risk adjustment methodology used by the Centers for Medicare and Medicaid Services (CMS) and other programs to determine the annual capitated payments for Medicare Advantage beneficiaries and to determine expected costs in Medicare Shared Savings Programs (ACOs) and newer Alternative Payment Models (APMs). Capturing HCC scores for your
Transitional Care Management (TCM) Face-To-Face Visit Requirements - 2024
This resource is intended for home-based primary care (HBPC) providers and practice staff and defines the 2024 face-to-face documentation requirements for Transitional Care Management (TCM) Face -To - Face visits and serves as a reference when creating visit templates or building components into an Electronic Health Record (EHR). The content was gathered utilizing Centers for
Transitional Care Management (TCM) Interactive Contact Requirements - 2024
This resource is intended for home-based primary care (HBPC) providers and practice staff and defines the 2024 requirements for the interactive contact required of clinical staff during the Transitional Care Management (TCM) period and serves as a reference when creating workflows or templates for outreach. The content was gathered utilizing Centers for Medicare & Medicaid
Chronic Care Management (CCM) Care Plan Template - 2024
Our Comprehensive Chronic Care Management Plan Template is a tool aimed at enhancing the coordination and quality of care for individuals with chronic health conditions. This template serves as a structured framework to assist healthcare providers in developing personalized and effective care plans, fostering a proactive approach to managing chronic illnesses.
Remote Patient Monitoring - 2024
This resource is designed to guide house call programs in the use of remote patient monitoring services to care for their patients following the expansion and highlighted need for telemedicine as a result of the COVID-19 pandemic.
House Calls Medical History Form - 2024
Semi-customizable & downloadable form used to gather important information about a patient’s past and current health status. This includes questions about the patient's medical history, including any illnesses or medical conditions, surgeries or hospitalizations, and medications they are currently taking. This comprehensive picture of a patient's health can help guide diagnosis and treatment decisions and
Patient and Provider Contract - Opioid Pain Medication - 2024
This contract serves as a vital document establishing a clear and comprehensive understanding between healthcare providers and patients regarding the responsible and appropriate use of opioid medications. This agreement is designed to ensure the safe and effective management of pain while minimizing the risks associated with opioid use.
Crossroads of Care: Managing Serious Illness in the Home (Session 4 of 4)
With the usage of value-based care models growing, the need for home-based primary and palliative care is on the rise. In many programs across the country, though, these two models have operated separately. There is, however, an increasing need for them to work more closely together to increase access to holistic, seamless care for patients
Crossroads of Care: Managing Serious Illness in the Home (Session 3 of 4)
With the usage of value-based care models growing, the need for home-based primary and palliative care is on the rise. In many programs across the country, though, these two models have operated separately. There is, however, an increasing need for them to work more closely together to increase access to holistic, seamless care for patients
Crossroads of Care: Managing Serious Illness in the Home (Session 2 of 4)
With the usage of value-based care models growing, the need for home-based primary and palliative care is on the rise. In many programs across the country, though, these two models have operated separately. There is, however, an increasing need for them to work more closely together to increase access to holistic, seamless care for patients
Crossroads of Care: Managing Serious Illness in the Home (Session 1 of 4)
With the usage of value-based care models growing, the need for home-based primary and palliative care is on the rise. In many programs across the country, though, these two models have operated separately. There is, however, an increasing need for them to work more closely together to increase access to holistic, seamless care for patients
The Impact of COVID-19 on HBPC Providers, Practices and Patients
Review this HCCIntelligence™ Webinar Recording from March 2020.
Ready, Set, Go: Planning Ahead to Administer the COVID-19 Vaccine to HBPC Patients
Review this HCCIntelligence™ Webinar Recording from February 2021.
Putting Person-Centered Decision Making into Practice
Review this HCCIntelligence™ Webinar Recording from May 2020.
COVID-19 Vaccine Administration
Review this HCCIntelligence™ Webinar Recording from January 2021.
Navigating COVID-19 Challenges with Telehealth
Review this HCCIntelligence™ Webinar Recording from May 2020.
Medication Management: Art of Deprescribing Medications in HBPC
Review this HCCIntelligence™ Webinar Recording from March 2020.
Managing Depressive Disorders in Homebound Patients
Review this HCCIntelligence™ Webinar Recording from December 2019.
COVID-19 and Home-Base Care-What Have We Learned
The world has changed significantly since the onset of the COVID-19 pandemic, but what did we learn about Home-Based Care and its role going forward? Review this HCCIntelligence™ Webinar Recording from May 2021 to explore this interactive discussion.
Leading Teams During a Crisis: COVID-19 and Beyond
Review this HCCIntelligence™ Webinar Recording from September 2020.
Introduction to Point-of-Care Ultrasound (POCUS) for the Home Care Provider
Review this HCCIntelligence™ Webinar Recording from November 2020.
Integrating Occupational Therapy into HBPC
Review this HCCIntelligence™ Webinar Recording from August 2020.
COVID-19 Updates: Advance Care Planning, Self-Care/Team-Care and Centers for Medicare & Medicaid Services Telehealth Changes
Review this HCCIntelligence™ Webinar Recording from May 2020.
Clinical Conundrums: Three Common Challenges You May Be Facing
Review this HCCIntelligence™ Webinar Recording from July 2019.