We encourage all our patients to take advantage of our coordination of care benefits as they will help us to provide improved quality of care and reduce your healthcare expenses in the long run.
We believe this will make your healthcare experience better than ever! To inquire about any of our Coordination of Care benefits please Contact Us.
Chronic care management are non-face-to-face services provided to patients who have multiple chronic conditions. The conditions are expected to last at least 12 months and normally require medication to maintain. The Centers for Medicare and Medicaid recognizes that CCM services are a critical component of health care that reduces overall health care costs. Although this program is primarily a Medicare funded program commercial payors do recognize the value for their beneficiaries.
PIMA will bill your insurance a monthly charge however, PIMA does not charge any out-of-pocket amount to our patients for the CCM program. Effective August 2021, the CCM program is 100% free to you as we accept what the insurance pays (if anything) as payment in full for service rendered.
PIMA’s dedicated Care Coordinators will make sure you are staying healthy in between office visits and verify there have been no sudden changes in your health. We are available to take your calls anytime and help you with prescription refills, referrals, specialists, and much more. Your provider is kept in the loop through our integrated model of care delivery. Our providers are wanting each patient to take advantage of this program, so they have made it 100% free for all patients. We do bill your insurance; however, whatever they pay, we accept as payment in full. Which means there is not an out-of-pocket cost to any patient for this program, even if the insurance does not pay. As we do try to ensure patients do not receive bills from our office, we may miss a couple along the way. No worries, if you receive a bill for these services, call our business office and we will take care of it for you.
In its simplest form, RPM involves the use of connect electronic tools that record personal health and medical data in one location. The data is then reviewed by a provider when there is an abnormal trend. Parameters goals are set for each patient when they are enrolled. Health systems are utilizing RPM services to treat both acute and chronic conditions and are not limited to clinical improvements alone. The care modality can also help break down hurdles related to social determinants of health, that is, social factors that negatively affect health.
This is a Part B Medicare service covered at 80% and if you have a secondary insurance program, it will cover the other 20% once your deductible is met. If you have a commercial insurance, you may participate however, the payment structure is dependent upon your insurance and plan.
PIMA’s dedicated Nurse Coaches which are Registered Nurses (RN) make sure the data you transmit is reviewed and compared to the parameters set by your Provider. If the data is not within the range, whether lower or higher, than the RN sends the data to our RPM team. This information is reviewed and someone from our office will reach out with further instruction. RPM is like CCM however, there are a few minor differences; RPM uses devices to monitor your vitals where CCM does not. As with both programs, your provider is kept in the loop through our integrated model of care delivery.
Annual Wellness Visits are yearly appointments to create or update a personalized prevention plan. This plan may help prevent illness based on your current health and risk factors. Keep in mind that the Annual Wellness Visit is not a head-to-toe physical.
To properly document your Annual Wellness Visit, we are required to check your height, weight, blood pressure, and other routine measurements. We are required to give you a health risk assessment, review your functional ability and level of safety, learn about your medical and family history, make a list of your current providers, durable medical equipment supplies, and medications. We must create a written five (5) to ten (10) year screening schedule or checklist, screen for cognitive impairment, including diseases such as Alzheimer’s and other forms of dementia, screen for depression, and provide health advice and referrals to heal education and/or preventive counseling services aimed at reducing identified risk factors and promoting wellness.
Due to the extensive information collected, these services are provided by a certified clinician before you see your provider. The results are shared with your provider to review and provide feedback as they deem necessary. Annual Wellness Visits are covered in full, by Traditional Medicare. If you have a Medicare Replacement Plan, we urge you to contact your insurance to inquire about your benefits.
Medicare fully covers and is 100% free to you.
Our staff will schedule your AWV in connection with an existing appointment. Our staff will advise you to come in 30 minutes prior to your appointment time. We will review your medications, current and past medical conditions, surgeries, family history, and much more. You will receive a detailed report of you AWV, so you have it for your records as well as place it in your electronic health record. This exam is not to be confused with an annual physical as it is separate and in addition to this service.
Dedicated to helping people talk about their wishes for end-of-life care is important to us. We believe that the place for this to begin is at the kitchen table – not in the intensive care unit with the people we love before it is too late. Together we make these difficult conversations easier. We can make sure that your wishes and those of our loved ones are expressed and respected.
You may obtain an Advance Care Planning (ACP)packet from your Provider or the Chronic Care Management Team. You may schedule this visit with your provider by calling 772-283-4428 Ext. 4.
Medicare fully covers and is 100% free to you, if performed during an AWV.
ACP is about making a decision now for the care you wish to receive should you become unable to speak for yourself. Planning involves understanding your choices for treatment of care and making decisions based on your preferences and discussions with your loved ones.
