You already spend time caring for your patients. Make it count.

Reimbursement FeaturesCalculate CCM OpportunityQuality Metric Bonuses

Reimbursement Features

Epharmix has easy-to-use time-tracking tools that help providers take advantage of Chronic Care Reimbursement opportunities.

Fast Patient Enrollment

After patients are enrolled, providers and staff can start tracking the time they spend coordinating care instantly.

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Easy Time Tracking

If a patient is prescribed an intervention, Epharmix can track time automatically when staff respond to alerts.

Even if a patient is not prescribed Epharmix, one-click time tracking tools can be used to log time coordinating care. Tasks that may qualify for reimbursement include:

  • Reviewing Epharmix data and patient charts
  • Refilling scripts
  • Analyzing lab results
  • Calling clinicians, facilities, or caregivers

See How

Automatic CCM Reporting

At the end of each month, Epharmix generates reports for Chronic Care Management. Each PDF report contains time logs and additional information to simplify reimbursement submission.

Download Example

What is my CCM Reimbursement Opportunity?

Adjust panel size, % with Medicare, and % of Medicare patients with two or more chronic conditions to reveal your reimbursement opportunity.

What is Chronic Care Management?

Chronic Care Management refers to a new billing code reimbursed by Medicare beginning January 1, 2015. The primary requirement is 20 minutes of non-face-to-face time that clinical staff spends managing each patient’s two or more chronic conditions.

Who can provide Chronic Care Management services?

Any licensed member of your clinical team may provide time that counts toward the 20 minutes of non-face-to-face time.

Which patients are eligible?

About 70% of Medicare patients are eligible for Chronic Care Management. Patient must have multiple (two or more) chronic conditions expected to last at least 12 months. Chronic conditions place the patient at significant risk of death,
acute exacerbation/decompensation or functional decline.

How much will I be reimbursed?

Up to $42.60 per Medicare patient per month (depending on the state), or $100,000 in annual revenue for 200 eligible patients.

How can Epharmix help?

The Epharmix system allows you to easily track time you spend calling patients and generate monthly reports you can submit as part of the CCM reimbursement claim. The reports include date, start time, duration, name of provider, and notes of services.

Quality Metric Bonuses

Epharmix interventions are designed with quality metrics in mind.


Healthcare Effectiveness Data and Information Set

Designed for providers and hospitals with pay-for-performance contracts or quality metric bonuses

CMS Stars

Quality Rating System

Designed for Medicare Advantage plans and providers


Hospital Readmission Reduction Program

Designed for hospitals interested in improving readmissions for specific disease states


Patient Satisfaction

Designed for providers and hospitals interested in increasing their Diagnosis-Related Group (DRG) reimbursement rates

HEDIS® is a registered trademark of National Committee for Quality Assurance. CAHPS® is a registered trademark of Agency for Healthcare Research and Quality. No claim is made to the exclusive right to use the trademarks apart from the marks as shown.

Performance Pricing

Our success is your success. We stand behind our research. Epharmix takes risk with you.

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