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Service line 02 — BPOFor Providers
Individual physicians, NPs, PAs and small practices. Medicare will pay you for chronic care management, remote monitoring and advanced wound care. It will also audit every minute you log. We run the program so you can practise.
These programs are simple to describe and brutal to run
CCM, RPM and advanced wound care all share a shape. Medicare endorses them. They pay every month. They reward exactly the work good doctors already do between visits. And they are all operationally intensive and compliance-sensitive in a way that catches practices out.
The failure points are never clinical. They're under-documentation, insufficient time tracking, staff turnover, inconsistent patient engagement, missed billing opportunities and audit vulnerability. A poorly structured program can trigger recoupments, lead to clawbacks, create False Claims exposure and damage payer relationships.
CCM is not difficult clinically. It is difficult operationally. CCM 101 — Paradygm Health Group
Practices consistently underestimate the staffing oversight burden, the compliance risk, the administrative load and the performance variability. That's the gap we exist to fill.
What we bring
- Registered-nurse leadership. Our organization is a team of RNs and nurse practitioners located nationwide, collaborating under a unified infrastructure — an outsourcing solution led by registered nurses.
- A dedicated care team. Each patient is assigned a dedicated Care Manager and a dedicated RN or NP. They serve as the primary point of contact for physicians — optimising patient compliance and outcomes while minimising your time.
- Purpose-built software. Advanced software tailored for care management: better communication, streamlined process, precise delivery. Combined with our team's Medicare expertise, this is what separates a program that survives an audit from one that doesn't.
- Documentation protocols and audit defence. Time logs, care-plan quality, consent documentation, staff qualification, supervision standards — built as infrastructure, not paperwork done afterwards.
- Revenue precision. Billing aligned to what's actually compliant and billable.
How you pay
You only pay for services that are billable — which means you can be profitable right away. We guarantee you will be cashflow positive in 2 months, at an estimated gross margin of 40%. We don't believe in long-term contracts: if you're not happy with us, give us one month's notice.
The MSO wrap-around
Beyond the programs themselves, our Management Services Organization covers the operational surface of the practice — a complete, ready-to-implement solution designed to integrate into your workflow with minimal disruption.
- Patient intake & eligibility verification — thorough medical-necessity and coverage checks
- Insurance verification & pre-authorization — approval secured before services are rendered
- Product procurement coordination — timely delivery of products such as allografts
- Treatment scheduling support
- Chart review & compliance audits — RN-led
- Billing coordination — correct coding, claims preparation, reimbursement tracking
- Mock audits & risk management — issues addressed before an auditor finds them
- Regulatory and policy guidance — current Medicare guidelines and payer policy
- Practice integration support
The programs we run for providers.
Chronic Care Management
≈$60 per patient per month for coordination you're likely already doing. Most primary care panels qualify at 30–60% of census.
CCM detail
Remote Patient Monitoring
Broader eligibility than CCM — one qualifying condition is enough. $90–$120 per patient per month when properly structured.
RPM detail
Wound Care & Skin Substitutes
Legitimate, covered treatment for qualifying chronic wounds — if, and only if, the documentation matches the LCD.
Wound care detailPharmacy-Led RPM Program
A remote patient monitoring program delivered in partnership with pharmacy. Details are being finalised and will be published here.
[PLACEHOLDER] — stand-in copy. Program scope, eligibility and delivery model still to be supplied.
Find out what your panel actually supports.
A short conversation will tell you which program fits your patients, what it's likely worth, and what it would take to run it properly.