Collection Ratio
Trusted by
AR Reduction
Revenue Increase
Serving Specialties
Strong principle care management solutions are central to effective PCM programs. Our PCM solutions validate care plans, care coordination notes, and non-face-to-face clinical activities. We ensure documentation clearly supports the time spent managing chronic conditions. This allows providers to focus on patient outcomes while maintaining clean, compliant records that fully support principle care management billing.
Principal Care Management (PCM) is designed for patients with one serious chronic condition that requires focused, high-touch care coordination between office visits. PCM enables providers, particularly specialty practices to deliver personalized care plans, proactive follow-ups, and continuous patient engagement, ensuring better clinical outcomes while supporting appropriate reimbursement for the time and resources invested in managing complex, condition-specific care.
Our chronic care management solutions begin with accurate patient enrollment and eligibility checks. We manage Medicare eligibility validation and enrollment tracking using proven chronic care management enrollment solutions. This ensures only qualified patients are enrolled and billed. By setting up CCM programs correctly from day one, we help practices avoid audits, reduce billing errors, and build a stable, compliant CCM foundation.
Real-time eligibility checks
Automated status monitoring
We provide dependable chronic care management billing solutions that follow CMS rules for time-based CCM services. Our team validates monthly time logs, confirms CPT thresholds, and reviews documentation before billing. This ensures claims are accurate, compliant, and submitted on time. With consistent and correct billing, practices can rely on predictable monthly revenue while staying fully aligned with Medicare CCM requirements.
Our solutions use AI-powered pre-billing checks to catch issues before claims are submitted. We review eligibility, consent status, time logs, and medical necessity upfront. This proactive process reduces denials, prevents payment delays, and protects monthly CCM revenue. By fixing problems early, we help practices maintain steady cash flow and avoid repeated billing issues.
Our comprehensive CCM and PCM revenue cycle management solutions support practices across the entire care management lifecycle, from patient enrollment and eligibility verification to coding, claim submission, payment posting, and A/R follow-up. With integrated care management services, real-time reporting, and proactive payer communication, we streamline workflows, reduce administrative burden, and minimize denials. Practices benefit from improved visibility into performance, stronger collections, and the confidence to scale both chronic and principal care management programs without added operational complexity.
Solo Primary Care Practitioners
Multi-Provider Primary Care Groups
Hospital-Based Primary Care Departments
Value-Based Care Organizations and ACOs
Chronic Care and Complex Care Management Clinics
Pain Management Practitioners
MedCare MSO delivers comprehensive denial management services for healthcare practices of all sizes. Our denial management in medical billing solutions includes:
Precise patient data extraction from EHR systems ensures accurate time logs and care plan documentation, supporting proper CCM/PCM billing.
We track patient care activities and monitor chronic conditions with specialized software, ensuring compliant billing for non-face-to-face care.
Real-time patient monitoring data is seamlessly integrated, ensuring the required time thresholds for 99454 and 99457 are met.
Automated code generation and CPT validation ensure CCM/PCM billing is compliant and timely with accurate coding for all services.
Accurate time tracking for non-face-to-face care ensures 20-minute monthly thresholds are documented and supported for billing.
We streamline patient enrollment, consent management, and eligibility verification, ensuring compliance with CCM service requirements.
Analytics platforms provide insights into care data, identifying trends and ensuring billing accuracy, while audit readiness is maintained.
Our AI-powered claims management tools help verify codes, manage denials, and ensure proper billing for accurate reimbursement of CCM/PCM services.
We manage device logistics and provide technical support to ensure smooth patient monitoring and data collection for CCM.
Our 24/7 nurse monitoring ensures continuous patient care with proactive calls and follow-ups to keep patients on track with their care plans.
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Owner, R.D.
MedCare MSO did a great job with our billing and helping clean up old AR. Regular updates and good communication were very appreciated.
Co-Owner, PCP
Chief Operating Officer, MAKO MEDICAL LABORATORIES
Chief Executive Officer, CARE NOW CLINIC
Chief Operations Officer, ION DIAGNOSTICS
Co-Founder, AW Care
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
Practice Owner, F&A Clinic
We have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage.
President/CEO, RLT
I am impressed with MedCare MSO’s promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases.
Practice Owner/FBH
We provide chronic care management billing services and support PCM CPT codes, including 99490, 99439, 99487, 99489, 99491, and PCM codes, with strict monthly time tracking and documentation validation before billing.
Our fee is a transparent starts from 2.99 % of net collections—no hidden charges.
We import your payer rules, set up ERA/EFT, and go live in 14 days.
CCM can be billed once per calendar month per patient when at least 20 minutes of qualifying non-face-to-face care is provided and documented.
Bill 99490 for the first 20 minutes of CCM time and 99439 for each additional 20 minutes in the same month when time thresholds are met.
CPT 99490 requires patient consent, an active care plan, and at least 20 minutes of non-face-to-face care per month documented by clinical staff.
Yes, Medicare covers CCM services for eligible patients with two or more chronic conditions expected to last at least 12 months.
Medicare does not cover therapy itself under CCM, but care coordination and management activities related to chronic conditions are covered.
CCM services can be billed by physicians and qualified healthcare providers, such as NPs and PAs, who oversee patient care. Our billing for CCM services supports providers by managing enrollment, documentation, coding, and compliance to ensure accurate and timely reimbursement.
Please provide the following information, so our team can connect with you within 12 hours.
Or call us as 800-640-6409
R.D.
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Most helpful is the open/responsive communication of their team with my office and each other, along with the specialty levels of expertise amongst my team for each aspect of RCM.
Kelly Ballou
Owner
R.D.
F&A Clinic
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
I would like to take time to recognize two members of MedCare MSO specifically. Moses for his exceptional support and dedication. He is always responsive, and knowledgeable, and goes above and beyond to ensure smooth operations. His professionalism and commitment make a huge difference in our day-to-day workflow. George also for his quick feedback and recognition of what is needed most. He is extremely efficient and always available for clarification and to share his knowledge and expertise.
I highly recommend MedCare MSO to any healthcare provider looking for a reliable and efficient billing partner.
RLT
Hello,
I am writing this email to express our appreciation of the MedCare MSO’s team and all they have done for our business at RLT. In the past year, we have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage. We went from having over $100k in uncollected/billed claims to now reaching near $100k in collection some months.
We are also happy to express our thankfulness that MedCare MSO is now helping us acquire new contracts with different insurance companies. This will in effect benefit everyone involved, allowing us to expand our services and provide more resources for our staff/business partners.
Please note special appreciation for the following:
David Lucas
Mario Ortega
Ambrose William
FBH
I have been a customer of MedCare MSO for one year. They have provided billing and credentialing services for my private behavioral health practice, and I am impressed with their promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases, and with their willingness to educate me and my staff about the ever-changing rules of medical billing and the best use of coding. This is a company I Trust with my billing needs.
Dr. Neufeld
Practice Owner
FBH
