How does it work?


1. Patient Activation

Practice will identify CCM eligible Medicare patients. Providers and office staff will be able to quickly and easily see eligible patients for outreach, program recruitment, and to schedule an appointment with a provider.

2. Automated Care Plan Set-Up

Upon uploading the consent form into your EHR, Oculus will pre-populate the patient’s Oculus Health Care Plan with relevant patient data from your EHR. Oculus provides customization of templates for care plans for each specific condition.


3. Care Coordination

When a patient comes to your clinic or away at home, you will have easy, quick and seamless access to the patient’s Oculus Health Care Plan and Care Adherence Data. The Oculus dashboard will also provide information regarding the patient’s monthly compliance level. This information will identify those patients who could benefit most from further outreach.


4. Patient Engagement

Through the Oculus Health application, care coordinators may directly communicate with the patient via text messages. Patients will have access to the Patient Portal where they may view their care plan, record their patient-reported outcomes and share their care plan with other providers. Oculus Health supports the connection.


5. Audit Compliance

The Clinic is responsible for billing Medicare CCM payments, however Oculus Health will assist your clinic with program compliance by tracking the time spent by the Care Coordinators on each patient. Oculus Health will ensure that every patient in the program will receive at least 20 minutes of time each month.


6. Performance Tracking

Ensuring that enrolled patients participate regularly and consistently each month is a significant challenge. The Oculus Clinic Dashboards will enable you to closely monitor efforts of your Care Coordinators, the proportion of your enrolled or eligible patients and their level of engagement. The Clinic Dashboards will also provide you with the amount of potential CCM payments that you have achieved and your clinic’s staffing needs going forward.