Eligibility Check Process

In this document, we will explore the process of checking patient eligibility for Chronic Care Management (CCM) and Remote Patient Monitoring (RPM). We will guide you through accessing the patient dashboard and interpreting eligibility indicators to understand why a patient may not meet the necessary criteria.

Step 1

To begin, navigate to the patient dashboard. This will allow you to view all relevant patient information, including eligibility checks.

Step 2

Upon accessing the patient dashboard, expand the view to locate the eligibility checks section. This section provides an overview of the patient's eligibility status.

Step 3

If the patient is not eligible for CCM, the CCM tab will be absent from the dashboard. In the eligibility section, a red mark will indicate ineligibility. Clicking the information icon will open a popup detailing the unmet conditions.

Step 4

To qualify for CCM, the patient must have a minimum of two chronic conditions. In this case, the check has failed as this requirement is unmet.

Step 5

Here, you will observe that the patient has only one chronic condition, resulting in CCM ineligibility. Similarly, eligibility checks are available for RPM when its tab is not visible.

Step 6

Thank you for following this process.