Advanced Care Planning Management Tool: Enhance Medicare Services

Advance Care Planning (ACP) is crucial for ensuring Medicare patients receive end-of-life care that aligns with their wishes. Leveraging an Advanced Care Planning Management Tool can significantly streamline this process, improve care quality, and optimize reimbursements for healthcare providers.

“Studies show a significant percentage of individuals are unable to participate in crucial end-of-life treatment decisions. Advance Care Planning ensures their voice is heard even when they cannot speak for themselves.”

Understanding Advance Care Planning within Medicare

The Centers for Medicare & Medicaid Services (CMS) defines Advance Care Planning as a vital face-to-face consultation between a healthcare professional (physician or qualified practitioner), the patient, and optionally family members or surrogates. This discussion centers on the patient’s healthcare preferences should they become incapable of making decisions in the future.

Medicare recognizes ACP as a payable service, acknowledging its importance in patient care. It can be incorporated into an Annual Wellness Visit (AWV) or provided as a standalone, medically necessary service under Medicare Part B. When delivered during an AWV, patients typically incur no copay, making it more accessible.

Distinguishing ACP from Hospice Care

While Advance Care Planning may encompass discussions about hospice care, they are distinct concepts. ACP is a broader process applicable to all adults, focusing on future healthcare wishes regardless of current health status. It may include conversations about hospice as one option within end-of-life care choices.

Hospice care, conversely, is a specific care pathway for individuals diagnosed with a terminal illness and a life expectancy of six months or less. It prioritizes palliative care to manage symptoms and enhance quality of life when curative treatments are no longer pursued.

HealthViewX: Your Advanced Care Planning Management Tool

The HealthViewX Advance Care Planning application is engineered to empower healthcare providers with a robust advanced care planning management tool. This HIPAA-compliant, scalable solution is designed to optimize your ACP workflow, enhance patient engagement, and drive value-based care profitability.

Unlike standard Electronic Health Records (EHRs), HealthViewX ACP facilitates detailed documentation of end-of-life discussions. It captures nuances related to living wills, durable power of attorney, organ donation preferences, and other critical aspects often overlooked in traditional systems.

Key benefits of this advanced care planning management tool include:

  • Personalized Care Plans: Develop tailored care plans specific to patient conditions. Detailed notes can be updated within each plan item, enabling precise monitoring of patient progress and preferences over time.
  • Customizable Workflows: Streamline ACP processes with adaptable workflows. Automation touchpoints can be configured for each patient, ensuring efficient and personalized care delivery based on individual needs.
  • Comprehensive Documentation: An integrated timer automatically records and documents time spent on various ACP activities. This feature is crucial for accurate CMS auditing and compliant billing practices, ensuring no billable time is missed.
  • Customized Reports: Simplify billing integration by seamlessly exporting service data to your existing billing systems. Generate detailed reports on patient interactions and care plan progress for insightful practice management and analysis.

Key Features of the HealthViewX ACP Application

  • Role-Based Access Permissions

    Enhance security and compliance by controlling access to sensitive patient information based on user roles within your organization.

  • EHR/EMR Integration

    Seamlessly integrate with existing EHR and EMR systems to ensure data consistency and streamline workflows, reducing manual data entry and improving efficiency.

  • Analytics, Reports & Charts

    Gain valuable insights into your ACP program with comprehensive analytics, reports, and charts. Track key metrics, identify trends, and optimize your service delivery.

  • Performance Metric Dashboard

    Monitor the performance of your ACP services in real-time. The dashboard provides a clear overview of key performance indicators, enabling proactive management and improvement.

  • Real-time Video & Audio

    Facilitate remote ACP sessions with integrated real-time video and audio capabilities. Expand access to care and improve patient convenience, especially for those with mobility limitations.

  • Appointment Scheduler

    Simplify appointment scheduling for ACP consultations. The integrated scheduler helps manage provider calendars and patient appointments efficiently, reducing administrative burden.

  • Unified Patient Care Record

    Access a holistic view of patient information with a unified patient care record. This feature consolidates relevant data in one place, supporting informed decision-making during ACP consultations.

  • CPT Code Generator

    Minimize billing errors and maximize reimbursements with the integrated CPT code generator. This tool assists in selecting the appropriate billing codes (99497, 99498) for ACP services, ensuring compliance and accurate claims submission.

CPT Codes and Billing for ACP Services

Medicare covers Advance Care Planning services for all beneficiaries. Hospitals, physicians, nurse practitioners, physician assistants, and other qualified practitioners are eligible to bill for ACP services using specific CPT codes:

  • 99497: For the initial 30 minutes of ACP, including explanation and discussion of advance directives, completion of forms if performed, face-to-face with patient, family, and/or surrogate.
  • 99498: For each additional 30 minutes of ACP (to be used in conjunction with code 99497).

It’s important to note that there is no annual limit on ACP service reporting for Medicare patients. However, subsequent ACP services should be justified by a documented change in the patient’s health status or evolving end-of-life care preferences. Accurate documentation, facilitated by an advanced care planning management tool, is crucial for compliant billing.

Elevate Your Practice with HealthViewX ACP

Discover how the HealthViewX Advance Care Planning application, a leading advanced care planning management tool, can transform your practice, improve patient care, and optimize your revenue cycle. Schedule a demo today to explore the full capabilities of this innovative solution.

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