PPCP Patient-Centered Medical Homes

Frequently Asked Questions

Can anyone be part of Patient Centered Medical Homes?

All patients of Palmetto Primary Care Physicians are part of Patient Centered Medical Homes, as it is a certification and model that affects all aspects of the care our practice provides. What differs from patient to patient will be the services and benefits that each person receives, which is based on how healthy a patient is and what health insurance plan they have. Patients who have chronic conditions, such as Diabetes, Hypertension, and Congestive Heart Failure, will receive services related to better managing their disease. Healthy patients without any chronic illnesses will benefit from our 24/7 triage services, the use of an integrated electronic medical record, and availability of same-day appointments. For those patients, PCMH will also serve as a safety net, should any life changes occur which necessitate more coordinated services.

Do I have to pay for care coordination services or to be part of Patient Centered Medical Homes?

No. Being part of PCMH is a benefit that you receive simply by being a patient of Palmetto Primary Care Physicians. Receiving specific PCMH services, such as telephone calls from a Patient Care Coordinator who has been assigned to help manage your care, is determined by patients’ health plans. A patient’s employer or managed care plan, such as South Carolina Medicaid, can request additional services for those they provide with health insurance. Some private health insurance plans may also include added PCMH benefits.

Why is “Care Coordination Services” showing up on my health insurance Explanation of Benefits (EOB)?

Any services or benefits provided through your health insurance plan are listed on an Explanation of Benefits. Care Coordination through PCMH is provided at no cost to you, whether it appears on an EOB or not. The insurance company has contracted with PPCP for those services on your behalf, but neither PPCP nor your health insurance company will ever try to collect from you for these services. Because of this, any cost that is listed on an EOB for the PCMH or Care Coordination services will not go toward a patient’s health plan deductible.

I received a phone call or letter from someone telling me she is my “Patient Care Coordinator” from my doctor’s office. Who is this person and why are they contacting me?

A Patient Care Coordinator (PCC) is a person assigned to help you manage or coordinate your care and is part of the care team. This person works closely with your provider and office staff, but physically works out of PPCP’s central corporate office. If you have been assigned a Patient Care Coordinator, you may receive a telephone call, email, or letter periodically from this individual. The goal of this correspondence is checking in to see if he or she can assist in making appointments, providing prescription vouchers, arranging transportation to appointments, getting a new glucometer or diabetic shoes, and the list goes on. What this person will discuss with you and assist you with is customized to you and based on your specific needs. In most cases, it is disease-specific, such as a call to a diabetic patient to help schedule a diabetic eye exam. In other cases, however, the PCC may be working with patients on staying up to date with important preventative exams and tests, like breast cancer screenings.

What if I don’t want to be contacted or to receive any educational materials, prescription discounts, or other assistance?

If you have been contacted by a Patient Care Coordinator, you may, at any point, opt out of receiving the added services and benefits. To opt out, simply let your Patient Care Coordinator or provider know that you would like to be removed from the care coordination program. Patients who decide to opt out can always request to be added back into the program, should circumstances change.

If you have other questions, concerns, or comments regarding PCMH, you can contact us at PCMH@palmettoprimarycare.com