Chronic Care Management Services

Helping physician and nurse practitioner practices scale their impact through the implementation of CCM & AWV.

Unsure how to implement Chronic Care Management in your practice?

Download this FREE GUIDE to see how CCM can both MULTIPLY YOUR BOTTOM-LINE and create BETTER OUTCOMES for your patients.

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Go from SUSTAINING to THRIVING in no time!

We put in the extra work so you're free to grow your practice intentionally



We are your 24/7 virtual and telephonic nurse support between office appointments.



We look for gaps in care and fill them in; resulting in less missed opportunities for care.



Leave the referrals and coordination between other providers to us. CCM takes care of that.



This is the goal of CCM/TCM. Its effective implementation makes this a reality.



Better outcomes equals better trust in your community and amongst your peers - resulting in more referrals.



CCM is designed to save money from unnecessary readmissions, which then gets funneled to you as reimbursement for a job well done.


Expertise and Commitment to Quality at Your Service

Shemika Mitchell RN, MSN, AGNP-C

Licensed Nurse for 26+ years

With varied nursing experience in all specialties of nursing. My cumulative experience informs the care pathways I choose for patients under my care.

Former SNF Director of Nursing x 9 years

Skilled at identifying gaps in care, coordinating needed care and navigating resources for my elderly population and their caregivers.

Expert Adult Care Practitioner

Masters-trained nurse with the authority to assess patients and diagnose sickness, order and interpret labs, create and manage treatment plans, all with a focus on prevention and improved quality of life.

I use my expertise to be your EXTENSION in the community.
My commitment to care leads to better outcomes and higher satisfaction for both you and your patients.

Chronic Care Management at NO COST to you

Using a secure and highly-rated platform, we offer and assist with the following...

Comprehensive Care planning & Medication Management

Early Identification & Notification of Adverse Symptoms

Referral & Care Coordination with Other Providers

Caregiver Education & Resource Navigation

Appointment Follow-up and Tracking

Treatment Plan Education & Reinforcement

**Reminder: CCM codes can only be applied towards qualified Medicare patients - patients with 2 or more Chronic conditions.

Lack of staff should not stop you from providing quality client care consistently

Let me help you fill in the gaps and account for the care you already give.

It's as easy as 1-2-3.


Will there be a difference in your patient outcomes and bottom-line if you implement CCM, or no? How will it impact your practice? Is it worth the trial?


Once in the affirmative, sign a simple agreement for contractual services, provide a list of qualifying clients to begin services on, and let me go to work getting consents and managing their care for you.


30 days later...
Receive your summary reports on care provided and time spent. Review and approve notes. Biller applies CCM-appropriate codes and sends off to Medicare. Save all notes for future auditing.

Ready to get started?

Check out our simple, transparent pricing.

Or book a demo or coffee meeting let's get all your questions answered

Pay Per Client on CCM Program

This is the fee for a single client

  • Patient consent & enrollment
  • Medication Reconciliation
  • Comprehensive care planning
  • Virtual care coordinantion (phone, text, email, video)
  • Patient tracking & weekly reports
  • Plus more...
  • Fee TBD
Book a Meeting

Pay for CCM Program Set-up

Education to help your nurses run the CCM program in-house

  • 1 FREE 60-minute consult
  • Staff education on CCM/TCM
  • Daily & weekly training with practice nurses
  • CCM/TCM program initiation
  • On-call assistance with CCM/TCM documentation
  • Stand-by assistance for 90 days post-program launch
Schedule a Consult

Still not sure how to proceed?

I get it. Medicare programs are not to be played with.

Book a meeting below so I can proceed to make you a believer in the possibilities of CCM 🙂

  • 1 FREE 60-minute consult
  • CCM Slide presentation to you and your practice staff
  • FREE material on CCM to share with your patients
  • Follow-up virtual meeting to answer all questions
Book a Meeting


Ready to get started?

Contact us or purchase above

Contact me

Got questions or comments? Don't hesitate to reach out.