Talk with us FOR PRACTICES & CARE ORGANIZATIONS
Find care and payment options for your setting.
Medical practices, nursing homes, skilled nursing facilities, assisted living, home health, hospice and long-term acute care organizations.
PROGRAM & INSURANCE EXPLORER
What could fit—and how would it be paid?
Explore without an NPI or contact details. Choose a practice and insurance route, then open the detailed guide.
Programs to explore for primary care
These are starting points for assessment, not eligibility decisions or a list of services to bill together.
Multiple qualifying chronic conditions and a whole-person care plan.
Read the program & requirements →APCMAdvanced Primary Care ManagementA practice ready to provide the full longitudinal primary-care model.
Read the program & requirements →RPMRemote Physiologic MonitoringPhysiologic readings that can inform treatment.
Read the program & requirements →TCMTransitional Care ManagementA qualifying discharge and a practice able to own the transition.
Read the program & requirements →BHIBehavioral Health IntegrationCoordinated behavioral-health follow-up with the appropriate team.
Read the program & requirements →PCMPrincipal Care ManagementOne unusually complex, high-risk condition when disease-specific management fits.
Read the program & requirements →Original Medicare: payment route
Published program rules and locality fee schedules provide a reference. Confirm the patient, qualified practitioner, setting and actual service before billing.
See rates or payer details →Compare programs across medical and other practices
“Explore” means this program is discussed in the practice guide. A dash means it is not highlighted, not that it is prohibited. Clinical fit and payment are separate.
CHOOSE YOUR PRACTICE
Open a guide for your specialty or practice type.
Clinical programs and operational services can help in different ways. See where your practice may fit and what it would need to do.
MEDICAL SPECIALTIES
Primary care
Connect chronic conditions, home readings, transitions, and behavioral-health needs to the patient’s primary-care plan.
See patient fit, workflow & payer checksCardiology
Support heart-failure and other appropriate cardiac patients between visits with clinician-selected readings, a response plan, and focused care coordination.
See patient fit, workflow & payer checksNephrology
A focused pathway for non-dialysis CKD and other appropriate kidney-care patients: useful home readings, condition-specific follow-up, and clear clinical escalation.
See patient fit, workflow & payer checksNeurology
Coordinate complex neurologic care between visits, especially after a stroke or for a high-risk condition that needs a focused plan and clear escalation.
See patient fit, workflow & payer checksPulmonology
Support appropriate respiratory patients with treatment follow-through, relevant home data, and a clear path for clinical escalation.
See patient fit, workflow & payer checksEndocrinology
Connect complex diabetes and other endocrine care to medication follow-through, appropriate home measurements, and clear coordination with primary care.
See patient fit, workflow & payer checksOncology and serious-illness care
Distinguish managing a serious condition from helping a patient navigate the plan and barriers around it.
See patient fit, workflow & payer checksBehavioral & mental health
Explore care operations and payment routes for psychiatry, psychology, social work and integrated behavioral-health teams.
See patient fit, workflow & payer checksOphthalmology
Retinal-imaging follow-through, referral closure, and selective monitoring or care-management assessment.
Explore eye-care pathwaysOTHER PRACTICES & PARTNERS
Dental & oral health
Medical–dental coordination, dental payer operations, and records integration without assuming routine dental qualifies for medical monitoring claims.
Explore dental pathwaysPhysical, occupational, and speech therapy
Help patients follow an appropriate treatment plan between therapy visits and bring useful progress information back to the therapist.
Examples, requirements, and financial pictureSurgical practices and ambulatory surgical centers
Coordinate discharge instructions, patient questions, and follow-up while checking whether a separate transition claim is actually available.
Examples, requirements, and financial pictureIndependent pharmacies and pharmacy partners
Separate plan-sponsored medication review from support provided to a treating practice and from ordinary pharmacy operations.
Examples, requirements, and financial pictureChiropractic practices
Improve patient follow-through and practice operations while keeping the Medicare chiropractic benefit and remote-care eligibility clear.
Examples, requirements, and financial pictureAcupuncture and integrative pain practices
Assess your actual clinicians, covered services, and operational needs before choosing a remote-care pathway.
Examples, requirements, and financial pictureHome-based and senior primary care
Connect medicines, caregivers, chronic conditions, and care transitions around the patient’s continuing primary-care team.
Examples, requirements, and financial pictureDo not see your specialty? Tell us about your patients and workflow → We will assess the clinical program, professional role, and payer route with you.
FACILITIES & RESIDENTIAL CARE
Find information for your organization.
Start with the actual care setting, existing services and responsible biller.
Nursing homes & skilled nursing facilities
Explore coordinated resident care, professional billing support and staffing without confusing facility payments with practitioner reimbursement.
Care options, payment route & implementation →Assisted living & residential senior care
Connect residents, caregivers and treating practices around care between visits.
Care options, payment route & implementation →Home health agencies
Coordinate with the treating practice while keeping agency services and professional care-management work distinct.
Care options, payment route & implementation →Hospice organizations
Explore staffing, revenue-cycle and coordination support around the hospice plan—not a default stack of additional care-program claims.
Care options, payment route & implementation →Long-term acute care hospitals & subacute settings
Strengthen discharge handoffs, billing operations and staffing, with a separate review of care after discharge.
Care options, payment route & implementation →SPECIAL PAYMENT SETTINGS
Does your organization use a different care or payment model?
FQHCs, RHCs, facility-based care, dialysis, home health, hospice, and value-based contracts need setting-specific review. Do not reuse an office-practice claim or rate without checking the applicable arrangement.
DESIGN A PRACTICAL STARTING POINT
Tell us where the workflow is breaking. We’ll show you where to begin.
Send us a message