Billing Company Phone Number: 650-386-0482
Billing Company Email: help@getathelas.com
Most Common Billing Questions
What are Chronic Care Management (CCM) and Advanced Primary Care Management (APCM)?
Answer: Chronic Care Management (CCM) is covered by Medicare and commercial insurance plans for eligible patients. Coverage requirements and patient costs vary by plan. CCM generally supports patients who have two or more chronic conditions expected to last at least 12 months. It supports the care you receive between office visits, including a personalized care plan, medication review, coordination with specialists, pharmacies and hospitals, and access to your care team when questions arise.
Advanced Primary Care Management (APCM) is a broader monthly primary-care service designed around each patient’s medical and social needs. It combines ongoing care planning, care coordination, help with transitions after a hospital or emergency-room visit, enhanced communication and other care-management services. Unlike traditional CCM, APCM is not billed according to the number of minutes spent each month.
All new patients who meet the eligibility criteria agree to enroll in these services when completing their new-patient registration paperwork. The program is similar to having concierge-level services, with most of the cost generally covered by Medicare or commercial insurance, depending on the patient’s plan and benefits.
“This does not mean you will be billed every month.”
A charge may apply when we receive and review laboratory results, X-rays, or other correspondence from subspecialists, or when you request services such as prescription refills, prior authorizations, referrals, or letters. Chronic Care Management (CCM) billing is based on documented time spent providing eligible services. Advanced Primary Care Management (APCM) is not time-based. These services allow us to employ trained personnel who can answer your phone calls and address your needs with guidance from your physician. They also help us offer same-day appointments when you are ill.
These services may appear as a separate monthly charge on your Medicare statement or commercial insurance Explanation of Benefits. A deductible, copayment or coinsurance may apply, depending on your coverage. If you have questions about a charge, please contact the billing company using the phone number or email above.
Why did I receive a bill when I did not see the doctor?
Answer: You received a bill for Chronic Care Management (CCM) or Advanced Primary Care Management (APCM) services, as explained above. These services may have involved your physician reviewing and interpreting laboratory or imaging results, addressing an urgent medical need by telephone or during a same-day walk-in visit, or promptly processing medication refills. This may include medications originally prescribed by another physician when you are unable to reach or obtain timely care from that prescriber.
Why did I not receive a statement?
Answer: We keep a credit card on file. When your insurance assigns a charge to you as patient responsibility, we automatically charge the card on file. Sending a statement after the card has been charged could cause you to pay the same amount twice, requiring us to issue a refund. For that reason, statements are not automatically mailed.
If you would like a statement, please call 650-386-0482 or email help@getathelas.com to request one.
What if I do not want to participate in Chronic Care Management (CCM) or Advanced Primary Care Management (APCM)?
Answer: Simply let us know by text or email. We will text you an opt-out form to sign and return. Once the completed form is received, you will be unenrolled. Going forward, you will be expected to call the main office line for all services and come into the office to receive those services face-to-face.