Health Coaching with Clinical Results
Your Partners in Health
Clinical health coaches are trained professionals who assist doctors and patients in providing a continuum of care. They provide support and encouragement for a variety of health issues, such as weight loss, stress reduction, the management of chronic conditions, such as diabetes and hypertension, tobacco cessation, addiction, and adjusting to a life-altering health event, like a heart attack.
Since healthy habits are formed outside of the doctor's office, having the ongoing support of a clinical health coach can increase patient engagement and accountability. This can help improve compliance and health outcomes.
For physicians, having a clinical health coach frees up valuable time to focus on chronic cases, maximizing workflow, increasing patient volume, and expanding the practice.
What Does A Clinical Health Coach Do?
While each patients care plan will differ, clinical health coaches provide assistance in:
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Creating actionable health goals and provides support towards self-managed care.
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Assists with the coordination of care across the care continuum (including home care, outpatient care, ER care, and hospital care) while maintaining strict patient confidentiality at all times
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Providing emotional support and encouragement which can help patients cope with the emotional impact of a chronic illness
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Health education, including health literacy
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Establishing healthy eating plans
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Reducing stress and anxiety, while providing effective tools to improve mental resilience
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Creating customized plans for physical activity
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Assists in medication management
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Linkage to community resources and referrals
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Coordinating social support services
Who Is Eligible for Clinical Health Coaching?
To receive clinical health coaching, patients must have two or more chronic conditions. Care for patients in health coaching falls under Chronic Care Management. CCM is one of several care management programs offered by Medicare. As the name suggests, CCM is a mechanism to manage patient’s care between regular office visits. The program revolves around monthly clinical engagement and care planning.
To enroll, patients must first consent verbally or in writing. They also must have two or more chronic conditions expected to last at least 12 months. These conditions must pose a significant risk of death, acute decompensation, or decline.
Some types of chronic medical conditions are:
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Arthritis (rheumatoid and osteoarthritis)
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Asthma
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Autism spectrum disorders
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Atrial fibrillation
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Cardiovascular disease
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Alzheimer's disease and associated dementia
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Cancer
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Chronic obstructive lung disease
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Diabetes
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Depression
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Infectious diseases like HIV / AIDS
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Hypertension
All CCM services are delivered through remote interactions.
As with all medical billing processing, CCM relies on specific codes in order to obtain reimbursement.
CCM covers 20 minutes of clinical staff time per month (CPT code 99490) for ongoing oversight, management, and care planning. In 2017, the CCM benefit was expanded to include complex CCM (CPT code 99487), which covers 60 minutes of time and allows for moderate to high complexity decision making. A second CPT add-on code (99489) was also included to allow for an additional 30 minutes of clinical staff beyond the initial 60 minutes of time each month under complex CCM.
All CCM services (regular and complex) must be provided under the supervision of a physician or non-physician provider (nurse practitioner or physician assistant).
CPT 99490
20 Minutes per Month
$50.00
CPT 99490 +99439
20 Minutes Per Month, Plus 20 Minutes of Additional time
$100.00
The average expected reimbursement for code 99490 is $42-50 depending on locality. While that number may initially seem small, it can have a dramatic impact on the practice’s revenues. With just 50 patients utilizing CCM services, that will generate an additional $2,000+ per month - without any additional effort from physicians.
You can only bill for one series of CCM services per patient, per month. For example, you can only submit a claim for either non-complex CCM or complex CCM. Not both.
In addition to revenue generated by CCM, follow-up appointments with patients enrolled in CCM, the following billing codes were created to reflect the value of the physicians’ time.
CPT 99491
30 Minutes
$83.00
CPT 99491 + 99437
60 Minutes
$142.00
How to Bill for Chronic Care Management
There are five items required when submitting a claim through CMS:
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CPT Codes for each program you’re managing for the patient
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ICD-10 codes tied to each of the conditions you’re managing within that program
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Date of service
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Place of service
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Provider name
How is Reimbursement Distributed?
What Physicians & Patients Receive with Clinical Health Coaching
Physicians
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The assigned Clinical Health Coach will ensure that quality are is carried out across the care continuum (including home care, outpatient care, ER care, and hospital care) while maintaining strict patient confidentiality
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Share the full treatment plan with physicians and providers
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Implement a range of interventions through counseling, motivational interviewing and coaching
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Provide patients with education on chronic diseases management on which the Health Coach will be trained
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Provide weekly progress notes
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Accurately record the amount of time spent
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Provide ongoing support and encourage patient accountability.
Patients
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Emotional support and encouragement to help cope with the emotional impact your chronic illnesses
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Online healthy cooking recipes and videos
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Tools and resources to effectively cope with stress and anxiety
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Customized plans for physical activity.
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Assistance in medication management
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VIP invitation to self-care and mindfulness workshops
Patient Testimonials
Marjorie F,
I was sure that I had good eating habits, but I was still unable to lower my blood pressure. My health coach Aletha was able to help my take a deeper look at my eating habits and make small changes. It has been 4 months since I've made those changes. My blood pressure is now consistently normal.
Robert, M
I like that my doctor and health coach work together to make sure that I am taking care of myself. It feels like my health has improved.
Lourdes, P
My husband and I wanted to lose weight and cut back on sugar, but we like to eat foods that taste good. The health coach that I worked with helped me create healthy recipes. I was surprised and happy that they actually tasted good!
Our Clients
About Us
Tula Health & Wellness is holistic health company based in Brooklyn, NY with a mission to help people live healthy lives- physically, emotionally and mentally.
Tula has provided clinical health coaching to numerous medical practices, as well as mindfulness workshops and training to corporate clients.
Are You Ready to Bring Clinical Health Coaching
to Your Practice?
Contact Us Today
Tula Health & Wellness
87 Richardson Street, Brooklyn, NY11211
info@tulahealthwellness.com / Tel. 718 309-9798
