Detailed Services

Every Service, Every Detail

A comprehensive breakdown of what Weethak delivers across all six service categories - with the specific components, descriptions, and practice benefits of each.

Service Area 01
Pre-Visit Revenue Optimization
Pre-Visit Planning
ServiceDescriptionPractice Benefit
Appointment PreparationReview appointment reasons, chronic conditions, care gaps, and preventive opportunities before visitEnsures visit is structured for maximum medical value
Lab / BW PreparationIdentify clinically appropriate labs based on diagnoses and payer guidelines (e.g., 3-month BW for Dx Diabetes)Captures additional reimbursable services
Revenue Opportunity IdentificationIdentify compliant revenue-generating focus areas: chronic care, preventive, wellness, unaddressed complaintsPrevents undercoded visits
Insurance Eligibility & VerificationReal-time eligibility, deductible, referral, and coverage confirmation before every visitReduces claim denials
Pre-Authorization ScreeningIdentify services requiring prior authorization before encounterPrevents non-paid services
Billable Opportunities: CCM (CPT 99439) · G2211 (Medicare longitudinal) · 99417 Prolonged Services - all coded compliantly
Service Area 02
Post-Encounter Documentation Support
Documentation
ServiceDescriptionPractice Benefit
Documentation Expansion (Not Modification)We do not change provider documentation. We expand clinically appropriate elements to support coding and medical necessity. Physician-Led Documentation Support.Protects compliance while supporting higher coding levels
Medical Necessity AlignmentEnsure documentation supports CPT and ICD-10 codes billed. We match documentation to the code - never downcode unnecessarily.Audit protection & optimized reimbursement
Revenue Strategy AdvisoryAdvise providers on legitimate add-on codes, prolonged services, care coordination, and chronic care billingEthical revenue growth
HCC / Risk Adjustment CaptureIdentify and document chronic conditions appropriately for risk-based contractsIncreases RAF and value-based income
Service Area 03
Coding Services
Precision Coding
ServiceDescriptionPractice Benefit
CPT & ICD-10 CodingAccurate coding aligned strictly with documentationClean claims & full reimbursement
NCCI Compliance ReviewEnsure proper bundling and modifier use per NCCI guidelinesPrevents recoupments and audits
Modifier OptimizationAppropriate use of modifiers 25, 59, 95, etc.Maximizes compliant billing
Service Area 04
Billing & Accounts Receivable Management
Billing & A/R
ServiceDescriptionPractice Benefit
Electronic Claim SubmissionTimely submission through clearinghouse integrationFaster payments
Denial Management & AppealsRoot-cause analysis and structured appeal processRevenue recovery
A/R Follow-UpActive insurance and patient follow-upReduced aging receivables
Payment Posting & ReconciliationERA/EOB posting with financial accuracyClean financial reporting
Service Area 05
Comprehensive Prior Authorization Management
Prior Auth
Service ComponentDescription
Authorization VerificationConfirm if service requires authorization before scheduling
Documentation CompilationPrepare supporting notes, labs, imaging, and medical necessity justification
Submission & Portal HandlingSubmit via payer portals, fax, or direct communication
Tracking & Follow-UpMonitor pending authorizations to prevent delays
Peer-to-Peer PreparationPrepare provider for insurance review discussions
Appeal & Retro-Authorization SupportStructured appeal letters and medical necessity documentation
Service Area 06
Administrative & Provider Support Services
Admin + CCM/APCM/GMI
ServiceDescription
FMLA & Disability PaperworkStructured assistance with medical forms
M11Q & Government FormsAccurate preparation (NY-specific or state-based)
Letters of Medical NecessityCustomized, detailed letters for procedures, DME, or increased care hours
Quality Measures SupportHEDIS, MIPS, and supplemental data capture optimization

CCM - Chronic Care Management

CPT 99490 ($66.13) · 99439 ($50.44) · 99487 ($144.29) · 99489 ($78.16) · 99491 ($89.18) · 99437 ($63.13)

Coordinated care for patients with two or more chronic conditions expected to last at least 12 months, delivered as non-face-to-face services and billed by time per calendar month.

PCM - Principal Care Management

CPT 99424 ($87.51) · 99425 ($61.46) · 99426 ($67.80) · 99427 ($54.11)

Focused management of a single complex chronic condition, billed by time per month, with distinct codes for provider versus clinical staff time.

TCM - Transitional Care Management

CPT 99495 ($220.11) · 99496 ($298.60)

Coordination during the first 30 days after a hospital discharge to prevent readmissions. One code is billed per patient, based on medical decision-making complexity.

APCM - Advanced Primary Care Management

HCPCS G0556 (~$16.00) · G0557 (~$54.00) · G0558 (~$117.00)

A bundled, non-time-based model billed once per calendar month per patient, stratified into three levels by complexity. It incorporates the work of CCM, PCM, and TCM into a single comprehensive service.

BHI - Behavioral Health Integration

CPT 99484 ($57.45) · CoCM 99492 / 99493 / 99494 (Verify CMS PFS) · APCM add-ons G0570 (~$58.00) / G0568 (~$162.00) / G0569 (~$146.00)

Behavioral health integration delivered as General BHI or the Psychiatric Collaborative Care Model (CoCM). BHI pairs with all care management programs.

RTM - Remote Therapeutic Monitoring

CPT 98975 ($21.71) · 98976 ($52.11) · 98977 ($51.44) · 98978 (Varies) · 98980 ($54.11) · 98981 ($41.42)

Monitoring of non-physiological data such as medication adherence and respiratory or musculoskeletal status via connected devices.

RPM - Remote Physiological Monitoring

CPT 99453 · 99454 · 99457 · 99458 · 99091 (all Verify CMS PFS)

Monitoring of physiological data such as blood pressure, weight, heart rate, and glucose via connected devices, with time-based management between visits.

GMI - CGM / Glucose Management

CPT 95249 · 95250 · 95251

Continuous glucose monitoring interpretation and billing for diabetic patients - a billable service many practices miss entirely.

Billing Compatibility: While a patient is on APCM, CCM, PCM, TCM, and medication management or oversight cannot be billed in the same calendar month (this includes non-complex lab result review, so a tele-visit cannot be billed in the same month as APCM for the same patient). APCM can be combined with BHI (via the add-on codes G0570, or G0568 / G0569 for CoCM), RPM, and RTM. BHI pairs with all programs.
The Weethak Portal

Care Management, Run for You

The software platform that powers every program above, built for billing accuracy, compliance, and proactive virtual care.

Real-time clinical and operational dashboards
Audit-trail time logging built for billing accuracy
Automatic CPT and HCPCS code assignment by time and program
Patient enrollment and monthly status across CCM, PCM, TCM, APCM, BHI, RTM, and RPM
Built-in compatibility and eligibility checks, including APCM exclusivity and insurance coverage
Role-based access for providers and clinical staff

Let's Build Your Ideal RCM Setup

Every practice is different. Tell us where you're losing revenue and we'll tailor a solution around it.