Chronic Care
Management
About Our CCM Services
At SwiftCare, we help with practices:
- Enroll eligible patients
- Document 20+ minutes/month of care
- Meet CMS compliance requirements
- Submit clean CCM claims for full reimbursement
- 133 million Americans live with at least one chronic illness.
- Practices can earn $42–$62 per enrolled patient per month.
- CCM enhances outcomes, reduces hospitalizations, and fosters stronger provider-patient relationships.
Challenges in CCM Implementation
- Identifying eligible patients accurately
- Ensuring proper documentation & time tracking
- Staying compliant with Medicare billing rules
- Managing staff workload and patient follow-ups
- Handling denied or underpaid CCM claims
- Our Services
Our Chronic Care
Management (CCM) Services
meet CMS requirements, and improve care outcomes — all while unlocking recurring monthly revenue.
Patient Eligibility Identification & Enrollment
We analyze your patient population to identify individuals with two or more qualifying chronic conditions, verify their Medicare eligibility, and guide them through informed consent and enrollment into your CCM program.
Personalized Care Plan Development
Our team collaborates with your providers to develop a comprehensive, patient-centered care plan that addresses the patient's medical, functional, and psychosocial needs, as mandated by CMS guidelines.
Time Tracking & Documentation
We accurately log and track the 20+ minutes of non-face-to-face care management time per patient each month, ensuring proper documentation to support billing and compliance.
Monthly Patient Outreach & Coordination
We conduct scheduled monthly check-ins with patients to assess progress, coordinate care between specialists, adjust care plans as needed, and document all communication thoroughly in the patient's medical record.
Care Team Communication & Coordination
We ensure seamless communication among all members of the care team, including specialists, pharmacists, and family caregivers, thereby reducing care fragmentation and avoiding duplicate services.
CMS-Compliant CCM Billing & Claim Submission
We prepare and submit clean CCM claims each month, coded appropriately and supported by fully compliant documentation, to ensure you receive full reimbursement without denials or delays.
Performance Reporting & Program Optimization
We provide detailed monthly and quarterly reports on program performance, including patient engagement, revenue generated, and quality of care, and offer recommendations to improve both patient outcomes and financial results.
Where We Deliver CCM — Coast-to-Coast Care
Idaho
New York
- Universal Compatibility
EHR & PM System Integration:
CCM Workflows That Fit Your Practice
Who We Support — CCM for Diverse Specialties
Chronic Care Management is not one-size-fits-all — and neither are we. SwiftCare specializes in tailoring CCM solutions to meet the needs of various medical specialties that care for patients with multiple chronic conditions.
- We regularly implement CCM programs for:
- Primary Care & Family Medicine
- Internal Medicine & Geriatrics
- Cardiology & Endocrinology (diabetes & heart disease focus)
- Pulmonology (COPD & asthma management)
- Nephrology (chronic kidney disease & dialysis)
- Rheumatology, Neurology, and Pain Management
- Behavioral Health (where applicable under CMS guidelines)
