alie details


Learn how we designed this turn-key course for the successful implementation of clinical services.

Background & Implementation
  • Impacting quality measures
  • Contracts and agreements
  • The clinical services: AWVs, CCM, TCM, RPM, BHI & PCM 
  • Medical coding and billing
  • Marketing your value
  • Business planning
  • Learn how to assess provider opportunities
  • Complete an AWV case, including verbal scenarios and billing
  • Complete a CCM case, including care plan components and billing
  • Evaluate RPM readings and trends to develop an RPM workflow
  • Evaluate a BHI and RPM case
  • Create your hook for collaboration
  • Evaluate the total opportunity for clinical services within an example clinic and how to design a contract

Program Objectives

  1. Describe the importance of the healthcare aims and how pharmacist-led clinical services meet and exceed the needs of innovative models of care, such as value-based payment models and the Quality Payment Program.
  2. Develop strategies and address the business complexity of obtaining an agreement with a provider or medical practice.
  3. Describe the components of medical billing, audit proof documentation, and the medical billing process.
  4. List the components of the Annual Wellness Visit (AWV) and describe the benefit of conducting the AWV for Medicare beneficiaries.
  5. Explain the rules for billing and documenting AWV encounters.
  6. Describe the different AWV add-on services and appropriate use of these services.
  7. Role play the pharmacist-led AWV through common scenarios addressed during the AWV.
  8. Create a 5-10 year preventive care plan for the AWV.
  9. Differentiate between complex and non-complex chronic care management (CCM) and how to determine the level of medical decision making.
  10. Explain the rules for billing and documenting CCM encounters for a successful and sustainable program.
  11. Define remote physiologic monitoring (RPM) and describe its purpose.
  12. Recognize the billing and documentation requirements for RPM.
  13. Describe the purpose of behavioral health integration (BHI).
  14. Recognize the billing and documentation requirements for BHI.
  15. Analyze strategies for ensuring internal and external business success.
  16. Identify strategies for sharing your value as a pharmacist to potential collaborators and begin steps to develop a successful clinical services program.
  17. Explain the factors that impact when it is appropriate to utilize an existing electronic health record versus an outside platform to maximize workflow during documentation.
  18. Analyze the needs of a practice and identify how to utilize non face-to-face services to meet those needs.
  19. Build an effective care team to maximize the delivery of CCM within a pharmacy.
  20. Identify appropriate non face-to-face services for a patient based upon a patient case.
  21. Categorize billing codes for a patient case based upon minimum time requirements for billing.
  22. Construct a personalized action plan that promotes implementation of clinical services.