For Providers

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 — what surrounds every program

These are the cross-cutting capabilities. They don't change program to program: whether you run Nurse-Led CCM, Pharmacist-Led RPM/RTM or a wound care program, this is the operational surface our Management Services Organization covers — 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