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Mediknocx helps healthcare providers manage and bill Medicare care management programs with structured support for patient eligibility, care plans, documentation, care coordination, coding, and claims. Our CCM and PCM services help practices manage ongoing care beyond routine visits while keeping billing workflows accurate and organized.
Medicare CCM and PCM programs are designed to improve outcomes for patients with ongoing health conditions. Mediknocx ensures these programs are properly implemented, documented, and billed according to CMS guidelines, reducing administrative burden for providers.
CCM and PCM are Medicare care management services that provide ongoing support beyond routine office visits. While both focus on coordinated care, they serve different patient needs.
Chronic Care Management (CCM) supports eligible Medicare patients with two or more chronic conditions expected to last at least 12 months and requiring ongoing care.
Principal Care Management (PCM) focuses on eligible Medicare patients with one high-risk or complex chronic condition that requires ongoing management.
Mediknocx helps healthcare providers manage the operational side of CCM and PCM, including documentation, coordination, eligibility workflows, and billing support, so your team can stay focused on patient care.
Mediknocx provides structured Chronic Care Management services that help practices manage the administrative and operational work behind ongoing patient care. Our team supports organized care-management workflows so providers can maintain accurate records, coordinate patient activities, and keep monthly CCM processes on track, including CPT coding and billing support when applicable.
Review patient information and support the enrollment workflow for eligible patients.
Help maintain organized care plans and related documentation.
Support ongoing communication, follow-up, and coordination with patients, caregivers, and other healthcare providers.
Organize care-management records and activity documentation for a consistent billing workflow.
Track recurring CCM activities and help practices maintain an organized monthly process.
Mediknocx provides structured Principal Care Management services that help specialty and primary care practices manage the administrative and billing work associated with ongoing PCM programs. Our team supports organized workflows for eligible patients while helping practices maintain accurate records, coordinate care activities, and keep billing processes on track.
Review patient information and support the PCM enrollment workflow.
Help maintain organized condition-specific care plans and related records.
Support communication and follow-up between patients, providers, and other members of the care team.
Organize care-management activities and supporting documentation for a consistent billing workflow.
Support accurate coding, claim preparation, and submission for applicable PCM services.
Track submitted claims and assist with unresolved billing issues.
Help practices maintain an organized monthly PCM process and identify outstanding activities.
With Mediknocx managing the operational side of PCM, providers can spend less time on administrative work and more time focused on condition-specific patient care.
Accurate eligibility checks and complete documentation help keep CCM and PCM billing workflows organized. Mediknocx helps practices review patient information, maintain required records, and support care-management documentation before claims move through the billing process.
Our team supports the operational workflow for eligible Chronic Care Management patients, including patient information review, enrollment documentation, care plan records, and ongoing care-management activity tracking.
We help keep CCM records organized so required activities and supporting documentation are available for billing.
For Principal Care Management, Mediknocx supports organized workflows around eligible patients, condition-specific care records, care plans, and ongoing care-management activities.
Our team helps keep PCM documentation consistent and ready to support applicable billing workflows.
Patient eligibility and enrollment records
Consent documentation where applicable
Care plan documentation
Care-management activity records
Provider and care-team coordination notes
Coding and billing documentation
Claim-ready record review
By keeping eligibility and documentation workflows organized, Mediknocx helps practices reduce administrative gaps and maintain a more consistent CCM and PCM billing process.
Accurate coding and claim preparation help practices maintain a consistent CCM and PCM billing workflow. Mediknocx reviews care-management documentation, supports applicable code selection, prepares claims, and helps track submitted services through the reimbursement process. Our team reviews documented services and supports medical coding requirements before claims are prepared.
Our team supports CCM billing workflows by reviewing documented care-management activities, validating applicable coding requirements, and preparing claims based on the services supported by the record. We also help practices maintain consistent monthly billing workflows and identify issues that could delay payment.
Medicare CCM code families include: 99490, 99439, 99487, 99489, 99491, and 99437, depending on the service and provider requirements.
For Principal Care Management, Mediknocx supports code selection, claim preparation, submission, and follow-up based on documented services.
Current Medicare PCM codes include: 99424, 99425, 99426, and 99427, with the applicable code depending on the provider or clinical staff performing the service.
Match documented services with applicable CCM or PCM billing codes.
Prepare claims using information supported by the patient record.
Review documentation for coding and billing consistency.
Submit claims through the appropriate billing workflow.
Track submitted claims and address outstanding billing issues.
Denial Management Services help address billing-related issues that may contribute to delayed or denied reimbursement.
By connecting documentation, coding, and claims into one organized workflow, Mediknocx helps practices keep CCM and PCM billing accurate, consistent, and easier to manage.
Mediknocx follows a structured workflow to manage CCM and PCM programs from patient enrollment through claim follow-up. Our process helps practices stay organized, maintain consistent documentation, and manage billing activities efficiently.
Our structured process helps practices reduce administrative workload, maintain organized documentation, and improve the efficiency of CCM and PCM billing workflows.
CCM and PCM programs require accurate documentation, consistent workflows, and timely billing. Mediknocx provides the operational support practices need to keep these programs organized while allowing clinical teams to stay focused on patient care.
We support CCM and PCM workflows with a focus on organized processes, documentation, billing, and applicable Medicare and payer requirements.
We help maintain documentation standards, review coding requirements, and prepare claims based on the services supported by the record.
From eligibility review through claim follow-up, our team manages each step with structure, consistency, and attention to detail.
We connect CCM and PCM activities with billing and A/R workflows to help practices manage outstanding claims and maintain a consistent revenue cycle.
We handle the administrative workload behind care-management programs so your team can spend more time focused on patient care.
Mediknocx is committed to accuracy, compliance, and performance. Our goal is to keep your CCM and PCM programs organized, your billing workflow consistent, and your practice positioned for long-term success.
Our experience across healthcare billing and care-management workflows reflects the scale and breadth of support we provide to healthcare practices.
HEALTHCARE PROVIDERS SUPPORTED
MEDICAL SPECIALTIES SERVED
HEALTHCARE BILLING & CARE-MANAGEMENT EXPERIENCE
CORE PROGRAMS CCM & PCM
Mediknocx supports healthcare providers and practices with reliable CCM and PCM care-management and billing support. Our structured workflows help practices manage ongoing care activities, documentation, and billing while reducing administrative workload.
Support for family medicine, internal medicine, and primary care practices managing patients with ongoing chronic care needs.
Care-management, documentation, coding, and billing support for specialty practices serving patients with complex or ongoing conditions.
Consistent care-management workflows that help multi-provider practices coordinate services across providers, teams, and patient populations.
Our Medical Billing Services for Small Practices provide additional operational and billing support for practices that need care-management assistance without expanding their internal administrative team.
Organized support for documentation, care coordination, and billing workflows within hospital-based healthcare teams.
Structured workflows that support coordinated patient care and consistent care-management processes.
Chronic Care Management (CCM) is a Medicare care-management service designed for patients with two or more chronic conditions expected to last at least 12 months. It provides structured support and care coordination beyond routine office visits.
Principal Care Management (PCM) is a Medicare care-management service focused on patients with one high-risk or complex chronic condition requiring ongoing management, care planning, and monitoring by clinical staff or physicians.
CCM is designed for patients with multiple (2+) chronic conditions, whereas PCM is tailored for patients with a single complex or high-risk chronic condition. Both programs aim to improve care coordination and outcomes beyond routine office visits.
Eligible patients must have two or more chronic conditions expected to last at least 12 months (or until death) that place the patient at significant risk of decline or functional breakdown. Practices should check current Medicare and payer guidelines for specific eligibility criteria.
Eligible patients are those with a single high-risk or complex chronic condition expected to last at least 3 to 12 months (or until death) that requires ongoing condition-specific care management and monitoring.
Required documentation includes patient eligibility verification, recorded consent, a comprehensive condition-specific care plan, logged time and care-coordination activities, and detailed clinical chart updates.
Mediknocx supports Medicare CCM code families (including CPT 99490, 99439, 99487, 99489, 99491, and 99437) and PCM code families (including CPT 99424, 99425, 99426, and 99427), depending on service duration and provider requirements.
Yes. Mediknocx supports claim review, documentation validation, and follow-up for CCM and PCM billing issues. Practices that need dedicated support for recurring or unresolved denials can also explore our Denial Management Services.
Yes. Mediknocx manages the complete workflow—from patient eligibility review and enrollment documentation to care plan tracking, CPT coding validation, claim submission, and payment follow-up.
Yes. PCM is highly relevant for specialty practices treating single high-risk or complex conditions (such as cardiology, neurology, endocrinology, etc.). Mediknocx provides structured administrative and billing support tailored to specialty workflows.
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