Ashley Schwartz, LMSW
Senior Project Manager
Michigan Institute for Care Management and Transformation (MICMT)
Kelsea Frazier – Billing and Operations Specialist, MPCA and Shelly Hathaway – Nurse Care Consultant, MPCA
Kelsea Frazier – Billing and Operations Specialist, MPCA and Shelly Hathaway – Nurse Care Consultant, MPCA
Kelsea Frazier – Billing and Operations Specialist, MPCA and Shelly Hathaway – Nurse Care Consultant, MPCA
April Kuehn, MPA, CPC
Melinda Hautau, RN, BSN
Integrated Health Partners
Optimizing Care Management Workflow and Billing
This webinar provides a comprehensive review of PDCM billing codes and payer-specific rules governing their use, including documenting medical necessity and tips to ensure accurate and timely billing. Participants will explore best practices for optimizing care management workflows within the care team to maximize care manager efficiency and patient experience of care.
As a general PDCM guideline, all participants should operate within their scope of practice and clearly document services provided, including information to support the medical necessity of the service. This sample standing agreement may vary based upon organizational structure and can be used as a guide in developing the particular agreement for each practice and/or organization.
For additional information, please refer to the PDCM Payment Policy and billing guidelines for BCBSM Commercial and Medicare Plus Blue PPO Members.