Chronic Care Management


AviTracks-CM offers complete functionality for managing patients with chronic diseases. 

With AviTracks-CM you can automate your entire care management workflow - from enrolling the patient, documenting medications, tracking phone calls and other interventions, to generating reports needed for billing purposes.  For providers participating in Medicare, this includes supporting documentation for CPT code 99490.


CCM Software Features:

  • Enables team-based care and care coordination across providers
  • Set up multiple care programs and protocols (TCM, CCM, AWV, etc.)
  • Create electronic care plans, assign teams and separate the tasks among physicians, nurses and coach coordinators
  • Create custom questionnaires for patient follow up
  • Record and log time for every patient interaction
  • Customizable workflow processes
  • Risk profiler - assign a risk level to each patient and adjust tracking based on risk
  • Flag patients by condition, risk or program for easy identification and monitoring
  • Implement across multiple care provider teams, letting each group focus on their work and also share critical information
  • Create reports and statistics by user - administrators can see staff workload and also identify highly efficient nurses, coaches and care coordinators
  • Create documentation for billing purposes including CMS CPT code 99490

System Architecture:

  • AviTracks-CM is a web based application
  • AviTracks-CM is offered as a Cloud SaaS solution (Software as a Service)
  • AviTracks-CM runs under encrypted technology (https) providing an extra layer of security

HIPAA Compliance and Security:

  • Microsoft Azure cloud hosted environment
  • Fully redundant data centers in the United States
  • HIPAA Compliant
  • Full Chain of Business Associate Agreements
  • Comprehensive suite of security technologies
  • Data fully encrypted during transit and at rest
  • Antivirus protection

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