Yes.  Chronic Care Management was created by the Centers for Medicare and Medicaid Services.  In most cases, your insurance company has actually identified you as qualified for this service.

Yes.  Chronic Care Management is recommended by your Doctor and/or care team.  Additionally, the program is endorsed by the American Medical Association and each of the major medical societies and has been identified by the Department of Health and Human Services as “a critical component of primary care that contributes to better health and care for patients, and even caregivers.”

Likely.  According to the latest research from Medicare, CareSync.com reports that in addition to improving health outcomes, Chronic Care Management has been shown to save nearly $1100 per patient per year due to improved health related outcomes, better utilization of insurance benefits, and fewer hospitalizations.

A recent survey indicates that nearly 70% of Doctors offer chronic care management or strongly plan to offer chronic care management this year.

The American Academy of Family Physicians suggests that we “sign up” all patients for Care Management, and then only enroll and provide these services to patients who qualify for the program based on Medicare guidelines.

If you meet the qualifications for enrollment, you will be contacted by our Care Management team to orient you to the program.

After you are enrolled in Care Management, a member of our Care Management team will reach out to orient you to the program and answer any questions.

We are also in the process of creating an in-depth online orientation program which will be released in early 2021.

In order to qualify for Care Management you must first:

• Qualify for Medicare (or a Medicare Advantage insurance plan), and
• Live with two or more chronic health conditions

Chronic conditions include things like arthritis, diabetes, high blood pressure, heart disease, lung disease, dementia, and depression as well as many other conditions.

Our Care Team will ensure that you qualify for this service before enrolling you in the Care Management program.

We have seen an exponential increase in the value of Care Management during the COVID pandemic.  Here are just a few examples:

• We are proactively providing COVID updates and education to help lower the risk for our Care Managed population
• We are actively monitoring vital parameters in certain patients to identify high-risk patients earlier
• We are actively monitoring ER visits and Hospitalizations to enhance provider communication and patient transitions
• We are prioritizing certain services, such as vaccinations, for our highest risk individuals
• We are creating new processes to manage preventive guidelines at a time when patients are trying to avoid unnecessary exposure

Most patients have no cost for Care Management.

While you will see an Explanation of Benefits (EOB) from your insurance carrier for Chronic Care Management, in most cases you will not be billed for Chronic Care Management.  The most commmmon exception to this is if you have not yet met your yearly deductible.  All Medicare patients are required by law to pay a $198 Medicare Part B deductible.  The good news is that even if it is applied to your deductible, Chronic Care Management, will not affect your overall out-of-pocket expenses.

While insurance generally pays for the service, in rare cases the insurance company may transfer this charge to “patient responsibility”.  If this happens to you, give our Care Manager, Ann, a call at (303) 730-2167 extension 036 so that she can take a look at your account.

During the COVID-19 pandemic, we are committed to ensuring that Care Management services are available to all patients without causing any financial burden.

If you receive a bill for Care Management and feel that this charge would create a financial hardship for you, let us know and we will see how we can help.

Unlike typical face-to-face medical care, Care Management is delivered asynchronously and by a Care Team.  While the Care Team works directly with your doctor to provide these services, the insurance claim may be submitted under the name of a different provider with oversight of the Care Management program.

Claims are submitted in this fashion strictly for logistical purposes and in accordance with Medicare guidelines. The submission of claims in this manner does not imply any additional provider-patient relationship other than the relationship that you have with your chosen primary care provider.

Reach out directly to our Care Manager, Ann, at (303) 730-2167 extension 036 and she can help walk you through the decision making process.

As you already realize, the Doctors at Altitude Family and Internal Medicine feel very strongly about the benefits and importance of Care Management.

However, you have the right to stop Care Management services at any time (effective at the end of the calendar month) by completing this written declination form required by the Centers for Medicare and Medicaid Services.  Declining Care Management services does not affect your ability to continue to see your physician at Altitude Family and Internal Medicine.

Prior to making this decision we would suggest a conversation with our Care Manager, Ann Lott, who can be reached at (303) 730-2167 extension 036.