The high cost of doing business has not been met with adequate increases in reimbursement by CMS and MA plans. And the increasing administrative burdens due to inappropriate MA plan practices have created an environment of financial uncertainty. This means TINs are running ever faster (and never catching up) needing to file more claims to offset decreasing reimbursement.

The solution, the Provider Tune Up platform can help your TIN increase revenue / pmpm without seeing more patients while maintaining your independence and/or control of the way you practice.

The platform offers a comprehensive suite of services:

• Medicare CCM Program Optimization
• MACRA Optimization
• HIE Optimization
• RAF Compliance Optimization
• Patient Outreach Optimization

(See our website for the important details on each)

Though most TINs did a good job meeting compliance in the past, due to complexity and the failure of vendors and health plans to provide TINs and their providers with the proper expertise, tools, and/or training, 98% are NOT meeting requirement benchmarks and targets on at least one, but for some, all five categories.

Administrators even boast about their cost of care, Quality scores, robust risk adjustment, abstract coding teams, QA audit teams, care coordination, and provider education. Unfortunately, they are still apathetic about action needed because up until now, fully meeting requirements has not amounted to any significant increase in revenue. This has now changed.

So, now when ownership, boards, and/or stakeholders ask why your TIN’s reimbursement has been reduced or why you failed to maximize reimbursement with the Medicare CCM Program, and/or the payment adjustment under the QPP & MACRA, and no one can explain why or do anything about it, ignorance or apathy will not be an accepted excuse. Don’t let this happen to you!

All our services are offered on a Clinic-by-Clinic basis and tailored to your clinic's specific needs, which can change from one year to the next. They require very little workload and no additional staffing requirements.

We make the decision on whether to invest in optimization services or stay the course with your ACO, vendor(s), or your own efforts, very easy.

Unlocking Financial Rewards starts with a Medicare CCM Program and RAF Verification Analysis, and maximizing your payment adjustment under the QPP begins with a MIPS Category Weights Data Analysis.

To determine the best course of action, we must first find out exactly where your TIN is hitting and where it is missing. We will utilize publicly available CMS data, and data you supply us from your QPP Detailed Final Report, ACO, MA Plan(s), Electronic Medical Records (EHR) system, Practice Management System, and/or other manual sources.

You should expect to spend an hour or two working with our teams to extract the data points required. The research, analysis, and report efforts will take several manhours to complete on each analysis. Within two business days, we will be ready to discuss the finding and recommendations with you via Zoom calls (One for MIPS and one for RAF) and present the Optimization Strategy Reports. These reports will identify any compliance gaps & vulnerabilities and provide the most effective recommendations and solutions.

The Provider Tune Up platform is the empowering solution that will ensure your TIN meets all requirements, improves Quality Scores, patient outcomes, provider utilization, the ability to act upon information immediately, and create accurate documentation that supports a patient’s diagnosis and satisfies potential Quality Care and CMS / MA audits.

In addition, increase billing encounters, reimbursement, and shared savings distributions, reduce Total Cost of Care, and unlock Medicare CCM Program revenue streams. A reasonable analysis and / or set-up fee applies.

Take a few moments to download our supporting materials.

• Live Well A.P.S. Provider Tune Up Brochure (pdf).
• CMS MLN CCM Booklet (pdf).
• Medicare Chronic Care Management for Seniors article (link).
• CMS Outreach and Education on CCM report (pdf).
• Mathematica 2017 report on CCM (pdf). (This is an important study, but a bit long.  See page 64 for the Bottom Line)
• 2024 CMS MIPS & PFS Final Rule Changes (zip).
• Qualified Registry - A Pathway to Success within MACRA (pdf).
• 2024 CMS RADV Final Rule Changes (pdf).
• CMS Proposes Major Changes to Medicare Advantage HCC Codes in 2024 (pdf).
• Diagnostically Connecting Data and Diagnoses (pdf).
• HEDIS Measure Subset Impacted Patient Engagement (pdf).
• NQS 2024 (pdf).
• AHA 2024 Med Industry Report (pdf).

Our Provider Partners are the leading professional service providers and consulting firms that specialize in the processes of the Medicare CCM Program, the QPP & MACRA, HIE, RAF Compliance, and Patient Outreach Optimization for financial ROI.

They support thousands of independent and hospital-based physicians & clinicians, multi-TIN, Medicare Advantage plan providers, and ACO and Advanced APM members. And our MACRA & HIE expert Provider Partner is a CMS Certified Clinical Qualified Registry (a CMS approved entity that collects clinical data from MIPS clinicians (both individual and groups) and submits it to CMS on their behalf for purposes of MIPS. Reporting options are limited to measures within MIPS and the Quality Payment Program).

They are all specialists that possess knowledgeable teams of people that handle all necessary tasks, provide frequent reporting, and useful analysis.

In a 30-60-minute Zoom call, we will review a CMS database look up that we will do on your TIN, which will show you how much more reimbursement we can help you capture, talk about the required analysis and the easy enrollment process.

Take a moment to download our NCND. Complete and email it to: support@livewellaps.com. Then reserve your Zoom call with us.

1. Click Here to download our Mutual NCND (pdf). We are NOT data miners. Your info will be kept strictly confidential. We will also be sharing proprietary and confidential information with you on the Zoom call.
2. Click Here to go to our Calendly page to reserve your Zoom call (complete the required fields and when asked “purpose of call,” click: Provider Tune Up).