Patient Enrollment

Q. What deems my patient eligible for CCM services?

A. Patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, are eligible for CCM services. Examples of chronic conditions include, but are not limited to, the following:

  • Alzheimer’s disease and related dementia
  • Arthritis (osteoarthritis and rheumatoid)
  • Asthma
  • Atrial fibrillation
  • Benign prostatic hyperplasia (BPH)
  • Cancer
  • Cardiovascular Disease
  • Depression
  • Diabetes
  • Hypertension
  • Overactive Bladder Disorder (OAB)
  • Prostate Cancer

Q. How do I order CCM services for a patient? (iSalus Software Customers)?

A. Follow the below instructions:

  1. Login to your database and from the MyTask list, click into the Pop Health MyTask
  2. If you are a rendering provider (or a staff member who is responsible for working the queue on behalf of a rendering provider) and do not see any patients listed, make sure your user setting is set to rendering provider:
  3. Click on your username in the bottom left hand corner of the screen to open user setup
  4. From user setup, make sure the correct username is selected on the left-hand side, then click the icon that has the red-shirted character to open advanced settings
  5. Once the advanced user settings screen appears, in the setting search bar search “chronic,” then click on the “Population health Settings 2” setting that appears
  6. From the Pop Health setting, from the Provider dropdown, select the appropriate rendering provider, once selected click the floppy disk to save the top toolbar
  7. If you would like to see a list of all eligible patients, regardless of rendering provider, type a % sign in the search bar and click the search icon (magnified glass)
  8. Once you have the appropriate list of patients, to order a patient for CCM:
    1. Select the patient you would like to order from the list, you’ll see all their information in regard to their CCM eligibility on the right-hand side once they’re selected.
    2. In the bottom right hand corner click “Order CCM”
  9. You will be prompted to confirm the rendering provider, then click yes or no to order the patient
  10. If you would like to order without having to confirm, you may select “Don’t show this message again,” which will remove this pop-up moving forward.

Q. How do I notify HealthWatch that a patient would like to discharge from the program?

A. You can submit a patients request to discharge from the program through this link: