What is CCM software, and how can a custom-built solution support Medicare-eligible chronic care patients?

Custom CCM software centralizes care plans, time tracking, patient communication, vitals, and follow-ups for Medicare patients with two or more chronic conditions. A custom-built platform lets clinics tailor workflows, automate required documentation, ensure CMS-compliant processes, and deliver proactive, coordinated care for high-risk patients without relying on rigid, off-the-shelf systems.

What Medicare billing requirements (99490, 99439, 99487, 99489) should a custom CCM platform support?

A custom CCM platform should automate time capture, support electronic care plans, record non-face-to-face activities, and map minutes to appropriate codes. It must distinguish between regular and complex CCM, manage add-on minutes, prevent double-counting, and generate audit-ready logs. Built-in compliance rules ensure every claim meets CMS documentation and supervision requirements.

Can custom CCM software streamline the patient consent workflow required by Medicare?

Yes, custom software can digitize consent collection, store it in the patient record, verify eligibility, and track consent status automatically. It ensures compliance with CMS requirements by documenting patient understanding of cost-sharing, program details, and the right to discontinue. Automated workflows eliminate manual paperwork and prevent enrollment or billing errors.

How does custom CCM software automate monthly time tracking and documentation for billable minutes?

Custom CCM software logs time automatically as staff complete calls, assessments, care-plan updates, coordination tasks, and messaging. Each action is time-stamped and linked to the patient’s record. The system aggregates minutes, prevents overlap with other programs, and generates monthly billing summaries, ensuring accurate, CMS-compliant documentation without manual spreadsheet tracking.

How can software support the differences between Regular CCM and Complex CCM under Medicare rules?

Custom software can separate regular and complex CCM workflows by tracking required time thresholds, medical decision-making complexity, care-plan elements, and add-on minutes. It can guide staff through the correct documentation, flag when a patient qualifies for complex CCM, and ensure billing codes match clinical complexity, simplifying compliance and reimbursement accuracy.

Can custom CCM platforms support combined billing for CCM and RPM in the same month?

Yes, a custom platform can track CCM and RPM activities separately, ensuring minutes aren’t double-counted and each program meets CMS criteria. Automated logic can assign tasks to the correct service, synchronize device data, and generate clean billing reports. This allows clinics to run both programs efficiently while maintaining full compliance.

How does custom CCM software integrate with existing EHR/EMR systems to prevent duplicate charting?

Custom CCM software integrates via FHIR or APIs to sync notes, care plans, vitals, assessments, and outreach activity directly into the EHR. Bi-directional syncing ensures providers' charts are updated once, and data appears everywhere it’s needed. This eliminates duplicate work, keeps records aligned, and simplifies billing, documentation, and care-coordination workflows across systems.

Which care activities can be tracked automatically in CCM software for compliant monthly billing time?

Custom CCM software can automatically record time spent on medication reviews, symptom checks, care-plan updates, coordination with specialists, patient or caregiver communication, vitals review, and education. These non-face-to-face activities count toward CCM billing. The system excludes ineligible tasks and creates CMS-ready logs to ensure accurate, compliant billing.

How can CCM software support better outcomes and reduce hospital readmissions through proactive care workflows?

Custom CCM software enables continuous patient monitoring, timely follow-ups, automated reminders, medication adherence tracking, and early detection of worsening symptoms. By surfacing risk alerts and coordinating care quickly, clinics can intervene before issues escalate. This proactive oversight reduces avoidable ED visits, stabilizes chronic conditions, and improves long-term patient outcomes.

Which providers can bill for CCM, and how can software ensure compliance with CMS supervision and documentation rules?

Physicians, NPs, PAs, CNSs, and CNMs can bill CCM while clinical staff deliver services under proper supervision. Custom software ensures compliance by maintaining electronic care plans, logging staff activities, validating supervision requirements, and preventing billing conflicts. Automated audit trails help clinics meet CMS documentation standards with far less administrative burden.

Trusted By 500+ U.S. Healthcare Providers

Reduce No-Shows with Custom Healthcare Digital Front Door Software

We build secure, patient-first digital front doors and patient engagement solutions that streamline the end-to-end patient journey through intelligent automation and 24/7 access—helping providers reduce appointment drop-offs.

Book 30-Min Demo

View 20+ Testimonials

Digital Intake
& Self-Scheduling

Omnichannel
Patient Engagement

Digital Patient
& Verification

Patient Engagement
& Self-Service Access

Digital Payments
& Engagement Analytics

EHR-Integrated
Patient Engagement

Omnichannel Patient Engagement Solutions That Keep Patients Connected

Engage patients across their preferred channels, text, email, portal, and mobile, while keeping communication consistent, timely, and compliant throughout the care journey.

Digital Intake & Self-Scheduling

Enable patients to book appointments, complete digital intake, and receive confirmations through a seamless digital front door, reducing drop-offs and improving access across teams.

Digital intake forms and self-scheduling workflows
Automated patient outreach and appointment confirmations
Omnichannel communication via SMS, email, and patient portals
Real-time availability and scheduling visibility

Custom EHR/EMR Software Dashboard Preview

Omnichannel Patient Engagement

Keep patients connected before and after visits with omnichannel engagement tools that deliver personalized messages, virtual care, education, and adaptive reminders based on patient response patterns.

Omnichannel patient engagement across SMS, email, portal, and mobile
HIPAA-compliant two-way patient messaging and notifications
Telehealth integration for virtual visits and remote follow-ups
Personalized education, surveys, and post-visit feedback collection

Digital Patient Check-In & Verification

Streamline patient arrivals with contactless check-ins using automated intake validation, eligibility verification, and self-service workflows to reduce errors, ease front-desk workload, and improve patient flow.

Mobile and kiosk-based patient check-in for on-site visits
Digital identity, eligibility, and intake verification
Patient-reported outcomes and screening tools captured digitally
Automated data capture synced across care teams and systems
Reduced front-desk dependency through self-service workflows

Ongoing Patient Engagement & Self-Service Access

Use real-time engagement data and self-service tools to understand patient behavior, improve follow-through, and support long-term care outcomes.

Patient portals for ongoing access to health records and care plans
Secure access to lab results, prescriptions, and visit summaries
Digital requests for prescription refills and follow-up services
Remote patient monitoring with real-time health insights
Continuous engagement to support adherence and long-term care

Digital Payments & Patient Engagement Analytics

Unify digital payments and engagement analytics to better understand patient behavior, payment patterns, and care participation across your digital front door.

Secure online payment options with digital receipts and statements
Payment history tracking and patient billing visibility
Engagement and experience analytics across access and follow-up workflows
Practice-level insights into patient behavior and retention patterns
Reporting dashboards to support operational and financial decisions

EHR-Integrated Patient Engagement Platforms

Connect your digital front door with EHRs and third-party healthcare systems to ensure seamless data exchange, coordinated workflows, and consistent patient experiences across the care continuum.

Seamless integration with EHR and practice management systems
Automated data exchange for scheduling, intake, and engagement workflows
Interoperability with hospital CRMs, patient engagement tools, and care platforms
Real-time data synchronization to support care coordination
Scalable integrations designed for hospitals and multi-specialty clinics

Real Results from Digital Front Doors Built to Perform

See how providers and healthcare organizations reduced no-shows, improved patient engagement, and streamlined access with custom digital front door solutions.

Lakeside Family Health

Primary Care Network

Challenge:

High appointment no-shows, manual intake processes, and inconsistent patient communication were impacting clinic efficiency and patient experience across locations.

Results:

Digital self-scheduling and intake workflows
Automated appointment reminders and follow-ups
Unified patient communication across channels

Clinic Locations

12+

Appointment No-Shows

-35%

Front-Desk Workload

-40%

"We were losing time and revenue to missed appointments and manual intake. A&I helped us build a digital front door that made scheduling and communication easier for patients and staff alike. The reduction in no-shows was noticeable within weeks. "

Mark Reynolds

Operations Director, Lakeside Family Health

SilverOak Multi-Specialty Clinic

Multi-Specialty Outpatient Practice

Challenge:

Patient access and engagement varied by department, leading to fragmented experiences, duplicated outreach, and poor follow-through on care plans.

Results:

Omnichannel patient engagement across SMS, email, and portal
Standardized communication workflows across specialties
Improved patient follow-up and care coordination

Specialties

18+

Patient Response Rates

+45%

Missed Follow-Ups

-30%

"Our biggest issue was consistency. With A&I’s digital front door solution, every department now follows the same engagement workflows. Patients respond faster, and our teams finally have visibility into the full patient journey. "

Angela Morris

Director of Patient Experience, SilverOak Clinic

Horizon Outpatient Care Group

Ambulatory Care Network

Challenge:

Manual check-ins and paper intake slowed patient flow, increased wait times, and placed unnecessary pressure on front-desk staff.

Results:

Mobile and kiosk-based digital patient check-in
Digital verification and intake workflows
Reduced in-clinic congestion and wait times

Providers

20+

Manual Check-In Time

-50%

Average Patient Wait Time

-25%

"Digital check-in transformed our front-desk operations. Patients arrive prepared, staff spend less time on paperwork, and clinic flow is smoother throughout the day. "

Jason Lee

Practice Administrator, Horizon Outpatient Care Group

Summit Care Partners

Regional Healthcare Network

Challenge:

Limited post-visit engagement made it difficult to keep patients connected, thereby affecting follow-ups, education, and participation in long-term care.

Results:

Patient portals and self-service access to health information
Automated follow-up reminders and education workflows
Ongoing engagement beyond in-person visits

Active Patients

50K+

Follow-Up Completion Rate

+38%

Portal Adoption

+32%

"The digital front door helped us stay connected with patients long after the visit. Education, reminders, and follow-ups are now seamless, improving participation across our care programs. "

Dr. Emily Carter

Clinical Operations Lead, Summit Care Partners

Ready to Reduce No-Shows & Improve Patient Engagement?

Explore how a custom digital front door can streamline patient access, communication, and follow-ups across your care network.

Book Free Consultation Call

Frequently Asked Questions

Q. What is a digital front door in healthcare?

A digital front door in healthcare is a unified entry point that connects patients to care through online scheduling, digital intake, communication, and self-service tools, delivered via healthcare digital front door software designed to improve access, engagement, and experience.

Q. Why do healthcare organizations need a digital front door?

Healthcare organizations need digital front-door solutions to reduce access barriers, streamline patient interactions, and meet rising digital expectations while improving operational efficiency, patient satisfaction, and care continuity across clinical and administrative workflows.

Q. How does a digital front door improve patient access to care?

A digital front door improves patient access by offering 24/7 self-service scheduling, mobile-friendly intake, automated communication, and timely reminders, allowing patients to find care, book appointments, and stay informed without relying on phone calls or office hours.

Q. How does a digital front door differ from a patient portal?

Unlike a patient portal, a digital front door manages the entire patient journey, including discovery, scheduling, intake, communication, and follow-ups, rather than focusing only on post-visit records, messages, and lab results.

Q. What features are commonly included in a digital front door platform?

Digital front door healthcare platform development typically includes digital intake and self-scheduling solutions, AI-powered patient self-service tools, patient engagement analytics and experience insights, automated reminders, payments, and secure integrations with clinical and administrative systems.

Q. How can a digital front door help improve patient engagement?

Through the development of patient engagement platforms, digital front doors support omnichannel patient engagement solutions, automated patient outreach and communication, mobile-first patient engagement for US providers, and personalized reminders that keep patients connected before and after visits.

Q. Can digital front door solutions help reduce appointment no-shows?

Yes, reducing no-shows with digital front door automation is achieved through self-scheduling, automated reminders, real-time confirmations, and proactive follow-ups that address missed appointments early and encourage patients to complete scheduled visits.

Q. How does a digital front door support appointment scheduling and check-in?

A digital front door enables digital intake and self-scheduling solutions that allow patients to book appointments, complete forms, verify eligibility, and check in digitally, reducing front-desk workload and improving clinic flow.

Q. Can a digital front door work with existing healthcare systems?

Yes, modern digital front doors are built as EHR-integrated patient engagement platforms, enabling seamless data exchange with EHRs, practice management systems, billing tools, and third-party applications without disrupting existing workflows.

Q. Are digital front door platforms secure and compliant with healthcare regulations?

Digital front door platforms are designed with security-first architectures, including HIPAA-compliant patient messaging platforms, role-based access controls, encryption, audit logs, and compliance safeguards to protect sensitive patient information.

Q. Who should invest in a digital front door—hospitals, clinics, or specialty practices?

A digital front door for hospitals and multi-specialty clinics is especially valuable for organizations managing high patient volumes, multiple locations, or complex workflows, while smaller practices benefit from improved access, engagement, and operational efficiency.

Q. What should healthcare organizations consider before building a digital front door platform?

Before investing in custom patient engagement software development, organizations should assess workflow complexity, integration requirements, scalability needs, patient demographics, compliance expectations, and long-term goals to ensure the digital front door aligns with care delivery and growth plans.

Reduce No-Shows with Custom Healthcare Digital Front Door Software

Omnichannel Patient Engagement Solutions That Keep Patients Connected

Real Results from Digital Front Doors Built to Perform

Ready to Reduce No-Shows & Improve Patient Engagement?

Frequently Asked Questions

Who We Are

PRODUCTS & SOLUTIONS