Chronic Care Management

Chronic Care Management (CCM) is a program designed to help patients better manage their chronic disease(s) through regular contact with and support from a Nurse Care Manager. The goal of the program is to keep your chronic condition(s) from worsening to the point you need emergency help or hospitalization. Along with your primary care provider, the CCM program equips you with the tools and support to make lifestyle changes and choices that improve daily living.

Why is my Provider recommending CCM? 

CCM provides qualifying Medicare beneficiaries with w dedicated Nurse Care Manager to provide additional support in dealing with your chronic condition(s). The Nurse Care Manager maintains contact with you on a monthly basis between scheduled office visits in order to better follow your treatment plan and achieve your health and lifestyle goals. This program is designed to support and supplement the ongoing care you receive from your primary care provider but does not replace your regular office visits or provider communication. 

The Nurse Care Manager will maintain communication with your primary care provider and care team to optimize care coordination. CCM services are provided monthly and continue as long as you need them, or until you no longer meet eligibility requirements. You are also able opt out of this program at any time. 

CCM and who pays for it? 

CCM is a Medicare Part B benefit and is billed through your provider's office. The CCM consists of your provider, Nurse Care Manager and other clinical and non-clinical healthcare team members participating in your care. Medicare Part B covers chronic care management with some secondary insurance plans covering any deductible and coinsurance balances. You are responsible for any cost sharing that may occur. Changes in your insurance coverage may impact cost sharing for this service. For questions regarding coverage, please contact your insurance plan directly. 

As a participant in the program, you will benefit from the following:

• Regular phone calls with your Nurse Care Manager between appointments to answer questions, monitor progress towards reaching your goals, review medication compliance, discuss barriers to managing your chronic condition(s) and offer additional resources or coaching as needed.
• A personalized comprehensive care plan focused on your chronic disease(s) and personal goals that is updated regularly.
• Monitoring of health care screenings and preventative care measures recommended for you. 
• Direct access to your Nurse Care Manager during business hours, Monday-Friday, 8:00 a.m. - 4:00 p.m, excluding holidays with after-hours contact information for your provider care team.

What happens next?

Your provider will answer any questions you may have at your next appointment. If you are interested in enrolling, please contact your primary care provider for assistance. Or, due to eligibility, you may receive a call from our enrollment specialist to discuss participation, answer any questions you may have, obtain verbal consent for services and schedule your initial intake phone call. 

We are excited to partner with you to provide support in acheiving your health goals and managing your chronic condition(s) at home.