Chronic Disease Management (CDM) & Comprehensive Care Management (CCM) Billing Services
In Manitoba, physicians are able to bill for chronic disease management of hypertension, ischemic heart disease, congestive heart failure, diabetes, and asthma. Manitoba Health has indicated they will expand the number of chronic diseases included in future. Comprehensive care management services for patients meeting specified age, and/or chronic disease criteria are another aspect of medical billing.
In order to be paid for the CDM billing, you first need to identify those patients that have the specific diagnoses covered, review their chart/lab results to ensure that you meet the criteria for billing the service, and complete and submit the CDM form to Manitoba Health for payment of the service. To be paid for CCM billing periodic data extracts submitted to Manitoba Health are required. For most busy clinical practices, this is a difficult, and time consuming task on an annual basis. We can help!
MD Practice Solutions’ CDM/CCM Specialists will review your patient lists and determine who qualifies for each of the current approved CDM tariffs. Our staff will review and submit the forms required to receive payment. In the case where some clinical aspects (lab or exam) need to be done in order to qualify for payment, an “Outstanding Deficiency” list will be generated and provided to the physician. You will then be able to determine if the patients require a follow-up visit or do not require the deficient test. Once completed, our staff will again complete the forms and submit for payment. As expected, we will review any rejected or unpaid CDM/CCM fees and resubmit to ensure you are paid for your work.
If you work in a personal care home, or chronic care environment, you are able to bill for the CDM/CCM codes as well. In these cases, we will generally send one of our staff to review your patient files, compile a list of patients that qualify for the various CDM codes, complete and submit the CDM forms that we are able to send, and compile an “Outstanding Deficiency” list for you. This will allow you time to review any deficiencies, and again, determine if a patient requires a follow-up visit or does not require the deficient test. Once completed our staff will again complete the forms and submit for payment. As always, we will review any rejected or unpaid CDM/CCM fees and resubmit to ensure you are paid for your work.