ALIE PROGRAM OBJECTIVES
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
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
- 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.
- Develop strategies and address the business complexity of obtaining an agreement with a provider or medical practice.
- Describe the components of medical billing, audit proof documentation, and the medical billing process.
- List the components of the Annual Wellness Visit (AWV) and describe the benefit of conducting the AWV for Medicare beneficiaries.
- Explain the rules for billing and documenting AWV encounters.
- Describe the different AWV add-on services and appropriate use of these services.
- Role play the pharmacist-led AWV through common scenarios addressed during the AWV.
- Create a 5-10 year preventive care plan for the AWV.
- Differentiate between complex and non-complex chronic care management (CCM) and how to determine the level of medical decision making.
- Explain the rules for billing and documenting CCM encounters for a successful and sustainable program.
- Define remote physiologic monitoring (RPM) and describe its purpose.
- Recognize the billing and documentation requirements for RPM.
- Describe the purpose of behavioral health integration (BHI).
- Recognize the billing and documentation requirements for BHI.
- Analyze strategies for ensuring internal and external business success.
- Identify strategies for sharing your value as a pharmacist to potential collaborators and begin steps to develop a successful clinical services program.
- 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.
- Analyze the needs of a practice and identify how to utilize non face-to-face services to meet those needs.
- Build an effective care team to maximize the delivery of CCM within a pharmacy.
- Identify appropriate non face-to-face services for a patient based upon a patient case.
- Categorize billing codes for a patient case based upon minimum time requirements for billing.
- Construct a personalized action plan that promotes implementation of clinical services.