It is not mandatory for FQHCs to furnish Chronic Care Management services for their patients. These services can be given in addition to any routine care coordination services already furnished as a part of the patient’s visit to FQHC. Though it is not mandatory for them to give CCM services, they can bill for the same if the CCM requirements are met. FQHCs are reluctant in giving CCM services to their patients as it is a laborious task. With increasing CCM requirements from CMS, FQHCs are worried about taking up the Chronic Care Management program. This is where HealthViewX can be useful. HealthViewX Chronic Care Management solution has features that solve most of the problems faced by FQHCs.

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1
Chronic Care Management Services In Federally
Qualified Health Centers
www.healthviewx.com

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Federally Qualified Health Centers (FQHCs) in the United States are non-profit entities comprising of
clinical care providers, that operate at comprehensive federal standards. The care providers in
FQHC are a part of the country’s health care safety net, which is defined as a group of health
centers, hospitals, and providers who are willing to provide services to the nation’s needy crowd,
thus ensuring that comprehensive care is available to all, regardless of income or insurance status.
FQHC is a dominant model for providing integrated primary care and public health services to low-
income and underserved population.
What are FQHCs?

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There are two types of FQHCs, one receives federal funding under Section 330 of Public Health
Service Act and the other meets all requirements applicable to federally funded health centers and
is supported through state and local grants. To receive federal funding, FQHCs must meet the
following requirements.
● Be located in a federally designated medically underserved area (MUA) or serve medically
underserved populations (MUP)
● Provide comprehensive primary care
● Adjust charges for health services on a sliding fee schedule according to patient income
● Be governed by a community board of which a majority of members are patients at the FQHC
What are FQHCs?

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The CMS introduced the Chronic Care Management program in 2015. It insisted care coordinators
give 20 minutes of monthly non-face-to-face care management services for beneficiaries with two
or more chronic conditions. It helps in managing their conditions, risk factors, medication
adherence, and coordination of care with other providers. In order to claim CCM reimbursements,
the practices must offer
● 24/7 access to care management services
● a platform for direct patient-practitioner communication
● ability to manage transitions between providers and settings
What is Chronic Care Management?

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Chronic Care Management in FQHCs
It is not mandatory for FQHCs to furnish Chronic Care Management services for their
patients. These services can be given in addition to any routine care coordination
services already furnished as a part of the patient’s visit to FQHC. Though it is not
mandatory for them to give CCM services, they can bill for the same if the CCM
requirements are met.
The CCM billing for FQHCs is a little different though. For CCM services furnished
between January 1, 2016, and December 31, 2017, FQHC can bill the under the CPT
code 99490. Payment is based on the Physician Fee Schedule (PFS) national average
non-facility payment rate for CPT code 99490. FQHC claims submitted using CPT code
99490 for services on or after January 1, 2018, will be denied.

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Chronic Care Management in FQHCs
For CCM services furnished on or after January 1, 2018, FQHCs can bill CCM
services under the general care management HCPCS code, G0511. CMS has set the
payment annually at the average of three national non-facility PFS payment rate for
CPT codes 99490, 99487 and 99484.
It is important to note that the 2018 payment of HCPCS code G0511 is $62.28. It is
high compared to the reimbursement of $42, CMS gives to practices other than
FQHCs under the 99490 CPT code.

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1. Increased reimbursements – FQHCs receive grants for treating their patients. When they
provide Chronic Care Management services to their patients, they get more grants from CMS.
This increases the revenue for FQHCs.
2. Improved patient satisfaction – Chronic Care Management services establish a long-term
connection with patients. The patients can reach out to the physicians at any time in need. This
improves patient experience and the FQHC will see more patients coming into their hospital.
Why should FQHCs give CCM services to their patients?

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HealthViewX CCM Software, the best fit for FQHCs
www.healthviewx.com

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FQHCs are reluctant in giving CCM services to their patients as it is a laborious task. With
increasing CCM requirements from CMS, FQHCs are worried about taking up the Chronic Care
Management program. This is when an electronic healthcare product like HealthViewX can be
useful.
HealthViewX CCM Software, the best fit for FQHCs

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Features of HealthViewX CCM Software

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1 Automated call log feature
After a call, care plan creation or any action related to CCM health services,
the system automatically adds call logs. It reduces the physician’s manual
effort is logging the call logs.

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Preventive Care Plans
2
HealthViewX solution supports care plans for the Chronic Care Management
service for a patient. The physician can create a care plan depending on the
patient’s health report. It helps in monitoring the patient’s vitals.

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Chronic Care Management
Analytics3
Dashboards with intuitive charts and tables give complete analytics of the
Chronic Care Management services. It provides a clear picture of the revenue
perspective

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4 Consolidated Reports
The physician can generate a consolidated report of the Chronic Care
Management services given for a particular period. This makes it easy for
the billing practitioner for getting the Medicare reimbursements.

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HIPAA Compliance
5
HealthViewX Chronic Care Management is HIPAA compliant. It facilitates
secure data exchange. The solution manages all patient-related documents
securely.

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HealthViewX Care Management and Chronic Care
Management solutions have features that suit
healthcare organizations best.
To know more about our solutions, schedule a
demo at www.healthviewx.com
Schedule a Demo with HealthViewX

17. Email: marketing@healthviewx.com
Phone: +1 (214)-461-0242Contact us anytime.
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