What is Chronic Care Management?

Chronic Care Management (CCM) is a Medicare-covered service that provides extra support between office visits for patients with two or more long-term health conditions. Your care team helps coordinate care, manage medications, monitor your conditions, and make sure you have the resources you need to stay as healthy as possible.

Why is Chronic Care Management right for me?

Chronic Care Management (CCM) gives you ongoing support between visits to help manage your chronic conditions, stay on top of medications, and address issues before they become bigger problems. Working with your pain specialist through CCM means your pain care is better coordinated, your symptoms are monitored more closely, and you have a care team you can reach between appointments.

How do I get started?

Simply complete the form below and one of our Chronic Care Coordinators will reach out to you within 24 - 48hrs to get started.

Chronic Care Management Consent Form

Patient First name

Patient Last name

Oklahoma Pain Specialists is excited to provide these new preventive services to its Patients. Chronic Care Management (CCM) services are designed to enhance your healthcare experience and improve the management of your chronic conditions. Before we can proceed with implementing these services, we kindly request your consent.

CCM involves the coordination and management of your healthcare needs by a dedicated care team. This team will collaborate closely with you and your healthcare providers to develop and implement a personalized care plan. The team will also provide regular chart reviews, medication management, and support for your chronic conditions.

By providing your consent, you acknowledge and understand the following:

1. Participation in CCM services is voluntary, and you have the right to withdraw your consent at any time without affecting your access to other healthcare services.

2. Your personal health information, including medical records and monitoring data, will be collected, stored, and transmitted securely in accordance with applicable privacy laws and regulations.

3. The CCM services are intended to complement your existing healthcare services and are not a substitute for in-person medical care.

4. You have the right to access and request a copy of your health information collected through CCM services.

5. CCM services are Medicare services that will be billed to your insurance once a month, all applicable cost sharing will apply.

6. Medicare allows only a single physician to provide and bill for this service monthly.

7. These services are not intended to replace emergency services or intended to notify us that you have an emergency that requires the Emergency Room’s services. Please call 911 if you have an emergency that requires immediate attention.

8. You were educated regarding CCM program and services and agree/understand to receive these services as part of your ongoing care.

We believe that these services will benefit your healthcare journey and look forward to continuing to collaborate with you to improve your health outcomes.

I, (patient and/or POA) hereby acknowledge that I have read and understood the above information regarding the Chronic Care Management (CCM) services offered by Oklahoma Pain Specialists

I voluntarily consent to participate in these services and authorize the collection, storage, and transmission of my personal health information for the purpose of CCM.

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