Most clinics using eClinicalWorks have hundreds of patients who qualify for Medicare's Chronic Care Management program — and aren't enrolled. Lumexity's CCM Data module identifies CCM-eligible patients across your entire population, tracks enrollment status, and shows exactly how much revenue your practice is leaving on the table. No manual chart reviews. No guesswork about who qualifies. One dashboard with your chronic patient population, their eligibility, and the reimbursement opportunity behind each one.
Dashboard preview
Medicare reimburses approximately $42–$62 per patient per month for non-face-to-face chronic care management services — billed under CPT 99490 and related codes. For a practice with 500 eligible patients, that represents over $250,000 in annual revenue.
$42–$62 per patient per month
500 eligible patients = $250,000+ per year
But most clinics don't capture it. Not because they can't deliver the care — but because they don't have a reliable way to identify which patients qualify.
CCM eligibility requires two or more chronic conditions expected to last at least 12 months. The data is in your eClinicalWorks system — buried across problem lists, diagnosis codes, encounter histories, and insurance records. Extracting it manually means pulling charts one by one, cross-referencing conditions, and verifying Medicare coverage. It's slow, incomplete, and almost impossible to maintain as your patient population changes.
The result: clinics that want to run a CCM program either start too small, enroll the wrong patients, or never start at all.
Lumexity's CCM Data module eliminates the discovery problem. It reads your eCW data, identifies the patients who meet CCM criteria, and gives your team a clear list to work from — with the revenue math already done.
Lumexity scans your eClinicalWorks patient population and identifies patients with two or more qualifying chronic conditions based on documented diagnoses, problem lists, and encounter history. The result is a filterable, sortable list of every patient who meets CCM criteria — updated continuously as your data changes.
See which eligible patients are already enrolled in your CCM program, which have been contacted but not yet consented, and which haven't been reached at all. Track your enrollment pipeline from identification to active participation, so your care coordination team always knows where to focus.
Every CCM-eligible patient represents a monthly reimbursement opportunity. The dashboard shows your total addressable revenue based on current eligible population, enrolled patients, and potential monthly and annual billing under CPT 99490, 99487, and 99489. See the gap between what you're billing and what you could be billing.
Not every patient with chronic conditions is a Medicare beneficiary. Lumexity cross-references patient eligibility data — using the same real-time insurance eligibility verification from the Office Eligibility Dashboard — to confirm Medicare coverage before your team invests time in enrollment outreach. Focus on patients who will generate reimbursement, not just patients who qualify clinically.
The module reads diagnosis codes, problem lists, and encounter data across your entire patient base and identifies those with two or more qualifying chronic conditions. No manual chart review needed.
Your team sees a complete list of CCM-eligible patients — segmented by enrollment status (not contacted, outreach in progress, consented, active) and sorted by revenue potential. Medicare coverage is verified so your outreach targets the right patients.
With a clear pipeline of verified eligible patients, your care coordination team focuses on enrollment and service delivery. Billing is aligned with the correct CPT codes and supported by the eligibility data your claims need to be accepted.
Lumexity CCM Data is designed for practice administrators, medical directors, billing managers, and care coordinators at clinics running eClinicalWorks — from primary care and family medicine to multi-specialty groups and FQHCs.
Whether you're evaluating the CCM opportunity for the first time, struggling to identify eligible patients in a large population, or running an existing program that isn't generating the revenue it should — this module gives you the data layer you need to make CCM work.
Clinics that specialize in chronic populations — geriatrics, endocrinology, cardiology, pulmonology — often find that their CCM-eligible patient count is significantly larger than expected. Lumexity shows you the real number.
Surface every CCM-eligible patient in your eClinicalWorks population — automatically, without manual chart review.
Quantify your CCM revenue opportunity: see the monthly and annual reimbursement potential based on your actual eligible population.
Focus enrollment outreach on Medicare-verified patients — reducing wasted effort and increasing your CCM enrollment-to-billing conversion rate.
CCM Data connects to your eClinicalWorks instance through a secure, read-only integration. It reads patient demographics, diagnosis codes, problem lists, encounter history, and insurance data to identify CCM-eligible patients and calculate revenue potential.
No clinical records are modified. No patient data is stored beyond what's needed for eligibility analysis. Your team accesses the analytics dashboard — Lumexity accesses the data it needs to populate it, and nothing more.
HIPAA-compliant. Audit-ready. No disruption to your clinical or billing workflow.
Lumexity identifies patients with two or more chronic conditions documented in their eClinicalWorks problem list or encounter history — conditions expected to last at least 12 months or until end of life. This follows CMS guidelines for Medicare Chronic Care Management eligibility under CPT 99490.
The CCM reimbursement opportunity is primarily through Medicare Fee-for-Service, though some Medicare Advantage and commercial payers also cover CCM services. Lumexity identifies all patients who meet the clinical criteria and then verifies Medicare or applicable insurance coverage so your team knows which patients represent a billable opportunity.
Yes. The dashboard segments your eligible population by enrollment status: not yet contacted, outreach in progress, consent obtained, and actively enrolled. This gives your care coordination team a clear pipeline and helps management track program growth over time.
Lumexity calculates potential monthly and annual CCM revenue based on your eligible and enrolled patient counts, using standard Medicare reimbursement rates for CPT 99490 (20+ minutes of non-face-to-face care coordination per month), CPT 99487 (complex CCM, 60+ minutes), and CPT 99489 (additional 30-minute increments). The dashboard shows both current billing and the gap to full capture.
CCM Data is designed to work with the Office Eligibility Dashboard for real-time Medicare verification. This ensures that when your team reaches out to a patient about enrollment, their coverage has already been confirmed — avoiding wasted outreach on patients who are clinically eligible but not currently on a billable Medicare plan.
That's one of its primary use cases. Before committing to staffing, workflows, and care coordination infrastructure, your practice can run the analysis to see exactly how many eligible patients you have and what the revenue opportunity looks like. The data makes the business case for you.
Identify every CCM-eligible patient in your eClinicalWorks population, see the revenue you're leaving on the table, and give your team a clear path to capture it.
