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Care Management That Keeps Patients on Track

Patients need more than a care plan. They need consistent outreach, documented follow-up, and support between visits. We run the monthly care management cycle so no patient falls through the cracks.

Real Impact from Day One

From day one, our team works inside your systems, reaches patients on schedule, documents every interaction, and keeps your care management program moving month after month.

20 - 40
%
savings on care management staffing

Care management without overhead

Avoid the costs of recruiting care coordinators. We staff, train, and run the monthly outreach cycle inside your systems.

Your gain:

Lower staffing costs, faster program launch, more clinician time for patient care.

99
%
compliance accuracy

Care time documented to CMS requirements

We record every call, message, and care activity with the timestamps and documentation needed to support billing.

Your gain:

Stronger claim support, fewer reimbursement disputes, a clear record of monthly care activities.

<
1
%
error rate on care plan data entry

Accurate updates in every patient record

Our coordinators update care plans in your EHR while the QA team reviews entries throughout the day for accuracy.

Your gain:

Cleaner patient records, fewer downstream corrections, more reliable reporting.

98
%
quality assurance score

Every interaction documented correctly

We review patient conversations and care notes against your protocol, then coach agents on any gaps we find.

Your gain:

Complete care plans, consistent documentation, records ready for payer review.

Quality assurance score

Security First

We are fully compliant with all necessary data protection protocols and implement advanced security measures across our operations. This approach reduces compliance risks, simplifies audit processes, ensures transparency, and increases customer trust in highly regulated and sensitive environments.

SOC 2 Type II

We enforce strict access controls, ensuring security and confidentiality across on-site and remote teams to maintain the integrity of client data.

GDPR

We collect only necessary personal data, retain it for defined periods, implement multilevel security, and provide full user control over it.

HIPAA

We safeguard protected health information through end-to-end encryption, secure access protocols, and real-time threat detection.

PCI DSS

We secure payment data throughout processing and storage, continuously monitoring our systems to identify and address potential risks.

Our Care Management Services

Our coordinators reach enrolled patients, update care plans, and document every interaction while AI supports scheduling and workflow management.

Chronic care management

Our coordinators make monthly calls, review medications, and update care plans between visits.

Program enrollment

We guide eligible patients through consent and enrollment, then start care management activities within days.

Care gap closure

We contact patients about missed screenings and document completed care gaps in your quality reports.

List Checks

Medication adherence

Our team tracks refill activity and follows up with patients when medications fall off schedule.

Teal person icon

Remote patient monitoring

Our coordinators review incoming readings and escalate results that need clinical attention.

Hospital icon

Transitional care

Our coordinators call discharged patients, confirm medications, and schedule follow-up appointments.

Care Management for Growing Healthcare Providers

Patient populations often grow faster than care management capacity. We provide the coordinators, outreach workflows, and documentation support needed to keep patients engaged across health plans, primary care groups, and specialty programs.

VP of customer experience, Medicare Advantage plan

When Star Ratings deadlines approach, open care gaps can outnumber available outreach staff by thousands. We work gap lists by measure and risk level, then schedule the visits needed to close them. Gap closure rates stay strong through the final quarter.

Lifecycle operations director, chronic care platform

Handoffs between enrollment and the first care call often break down as volume grows, leaving new patients waiting weeks for contact. We assign each consented patient to a named coordinator within one business day. First-touch timing stays consistent as enrollment scales.

Director of customer experience, behavioral health organization

Documentation quality can drift across a growing coordinator team, with audit issues surfacing months later. We route every note through a shared template and weekly quality review process. Documentation quality stays consistent across the entire team.

A cheerful doctor reviews medical information with a happy senior man, creating a positive and supportive healthcare experience

Head of customer success, value-based primary care group

Without evening coverage and multilingual outreach, a large share of patients never answer the phone. We contact patients during the hours they are most likely to respond, in 45+ languages where needed. Reach rates stay consistent across every patient segment.

Unlock your hidden CX savings with Helpware

Get ROI projection for current support needs.

45
8/5 (Mon to Fri)
12/5 (Mon to Fri)
12/7 (Mon to Sun)
24/7

-40% annually

$

/monthly costs with Helpware

vs

$

/internal team costs (approx)

$0000

Your requirements fall outside our standard parameters.

Let's discuss your results

Fill in your details to schedule a consultation.

-40% annually

$

/monthly costs with Helpware

vs

$

/internal team costs (approx)

$0000

Your requirements fall outside our standard parameters.

Your savings report

-40% annually

$

/monthly costs with Helpware

vs

$

/internal team costs (approx)

$0000

Your requirements fall outside our standard parameters.

Support staff included in the package:

Shared Team Leader

Shared L&D Specalist

Shared QA Specialist

Account Executive by default

Shared Ops Delivery Manager

Admin/Finance/Legal support for the agents by default

1-2 Dedicated Team Leaders

Shared L&D Specialist

Shared to 1 Dedicated QA Specialist

Shared Ops Manager

Account Executive by default

Admin/Finance/Legal support for the agents by default

Shared Real Time Analyst

2-5 Dedicated Team Leaders

0,5 to 1,5 Dedicated L&D Specialists

1-2 Dedicated QA Specialists

Up to half of a dedicated Ops Manager

Account Executive by default

Admin/Finance/Legal support for the agents by default

1 Dedicated Real Time Analyst

Ready to get a personalized estimate for your team?

Contact us for a personalized assessment tailored to your specific needs.

*These projections are estimates for informational purposes only and do not represent a formal offer. Contact us for a personalized quote.

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AI-Enabled, Human-Led Care Management

Software finds the patients; people do the talking. AI identifies eligible members, prioritizes outreach, and flags what needs attention this month. Our coordinators then call patients, discuss what is happening between visits, and document the information your care team reviews the next day.

What AI tech does

2+ chronic conditions identified for eligibility

Scans claims and chart data for the two-or-more chronic condition requirement, then builds the outreach list for your team.

20 minutes tracked toward the CCM requirement

Records every interaction and totals monthly care management time before a claim reaches the billing queue.

7-day follow-up window monitored automatically

Flags hospital discharges and emergency visits, then queues outreach within the required seven-day follow-up period.

AI-assisted care notes

Drafts care notes after each interaction, giving coordinators a structured starting point before information enters the patient record.

ai people

What our people do

Motivational interviewing

Ask open-ended questions that uncover why a patient stopped taking a medication, then help them work through the barrier.

Hidden patient barriers

Catch transportation, cost, and caregiver issues no risk score sees, then connect patients with the right resource.

Escalation judgment in the moment

Decide when a symptom needs clinical attention, then pass it to your nurse line with the full context.

Consent conversations that land

Explain the program, the cost share, and the opt-out process in plain language until the patient is ready to enroll.

Transparent stairs on a light green background

A Five-Stage Approach to Care Management

Defining success

We agree on the eligible population, enrollment targets, escalation rules, and the quality measures your program tracks each month.

Building your team

We recruit coordinators with chronic care experience, run background and HIPAA checks, then build a team that matches your patient volume.

Training on your brand

We teach your protocols, scripts, and EHR workflows, then certify each coordinator on live calls before they manage patients on their own.

Running live operations

We run the monthly cycle, from patient outreach and care plan updates to clinical escalations and billing-ready documentation.

Refining performance

We review reach, enrollment, and closure rates with you each month, then adjust scripts, call windows, and staffing based on the results.

Why Helpware CX?

Care management only works when every patient gets the attention they need, month after month. We build the people, processes, and oversight that keep it on track.

Woman with blonde hair smiles and shakes hands with another person

Customer-centric culture

Our clients rate our work at 90% CSAT because we follow their processes closely, communicate consistently, and deliver the level of service they expect from an extension of their team.

Pink and yellow balloons with smiley faces against a blue sky

Contagious positivity

We excell at engaging our teams. An engaged team stays longer, learns your workflows faster, and delivers more consistent care management support month after month.

Scaling without borders

We scale coverage across regions, time zones, and languages, so your patients receive timely outreach without adding pressure to your internal team.

Man in pilot uniform giving a thumbs up inside an airplane cockpit

Trusted partnerships

Clients stay with us for more than five years because we deliver measurable results, report performance transparently, and improve programs over time.

90
%

CSAT

86
%

ESAT

19

locations

5
+

years average length of client partnership

Your Trusted Care Management Partner

We help healthcare organizations reach more patients, document every touchpoint, and keep care management programs running month after month without adding internal headcount. Enjoy the benefits from day one.

4.8

Clutch

(46 reviews)

4.9

G2

(29 reviews)

4.8

Gartner

(5 reviews)

5.0

UpCity

(9 reviews)

4.3

TrustPilot

(26 reviews)

4.9

GoodFirms

(11 reviews)

Ready to Scale Care Management Without More Headcount?

Got Questions?
We Have Answers.

What are care management services?

Care management services cover the ongoing work between visits, including enrollment, monthly outreach, care plan updates, medication reviews, and specialist coordination. Medicare reimburses many of these activities through Chronic Care Management (CCM) and Advanced Primary Care Management (APCM) programs.

What is the difference between care management and case management?

Care management supports a defined patient population over time, most often people with chronic conditions who benefit from regular outreach and monitoring. Case management focuses on a specific event or issue, such as a hospital discharge or authorization challenge, and typically ends once that situation is resolved.

Which care management programs does Medicare pay for?

Medicare reimburses several care management programs, including Chronic Care Management (CCM), Transitional Care Management (TCM), Principal Care Management (PCM), and Advanced Primary Care Management (APCM). APCM payment rates introduced in 2025 range from $15.20 to $107.07 per patient per month, depending on patient complexity.

How many eligible patients enroll in a care management program?

Enrollment rates are often lower than healthcare organizations expect. Federal data shows that roughly 4% of eligible Medicare beneficiaries participated in Chronic Care Management programs through 2023. Structured outreach, clear enrollment workflows, and consistent follow-up typically improve participation.

Does outsourcing care management change how the program bills?

No. Your organization remains the billing provider. CMS allows qualified auxiliary personnel to furnish care management services under general supervision, while clinicians retain responsibility for billing. We document consent, time, and care plan activity in your system so each claim aligns with the supporting records.

Who owns patient data when care management is outsourced?

Your organization retains ownership of all patient data. Our coordinators work within your EHR and care management platforms under a business associate agreement, so records remain in your systems. Access is controlled through role-based permissions and governed by HIPAA, SOC 2 Type II, ISO 27001, and GDPR requirements.

How long does an outsourced care management program take to launch?

Most organizations begin with a pilot program that runs for 30 to 60 days within a defined patient population before expanding. Depending on scope, we can scale from pilot operations to several hundred coordinators within 90 to 120 days, with workflow, protocol, and EHR training included throughout the rollout.