Healthy Plus and its partners go far beyond meeting the minimal requirements to bill for Chronic Care Management.
Sending postcards out to all eligible patients.
Following up with phone calls to enroll eligible patients.
Generating a Care Plan to be shared with the patient and all providers
Assigning a Medical Assistant to develop a 1:1 relationship with each patient, and oversee Care Plan adherence for that patient.
Medical Assistant and Patient together create a plan of action for the patient’s monthly Care Plan oversight and whether the patient needs high tech, low tech, or no tech monitoring.
We provide a platform for patients to interact with independently to self report Care Plan adherence, namely medication and activity adherence.
Patients receive experiential rewards for self reporting that are redeemable for gift cards and more. This has strongly contributed to high engagement rates and longevity of patient enrollment.
Integrate with Bluetooth enabled devices such as blood glucose meters, Apple Health Kit, and wearable activity trackers, enriching the quality of patient health data and providing a snapshot of patient health at any time.
Monitoring the data both manually and automatically to identify when a patient is not adhering to his or her Care Plan.
When a patient shows signs of veering off his or her Care Plan, the assigned Medical Assistant makes an appointment with the provider on the patient’s behalf.
All gathered data is available to the provider at any time, and automatically uploaded to the patient’s EMR file when a patient has an appointment for signs of Care Plan regression.
All documentation requirements for billing purposes.
Billing reports made available to the clinic/provider on a monthly basis
Repeating this process monthly as new patients become eligible, and maintaining existing relationships with enrolled patients.