Care Management Software

Your staff. Your patients.
Your revenue.

Praventa also offers its proprietary software as a standalone service. Your own employee clinical staff run every program, and we give them the tool that makes it manageable.

Request a Demo See How Billing Qualification Works →

Most care management programs don't fail clinically.
They fail on paper.

The care gets delivered. The revenue doesn't follow. Three gaps account for nearly all of it.

Time nobody logged

  • Staff document in the EHR, then reconstruct their minutes from memory at month end
  • Time spent reviewing vitals, coordinating with pharmacy, or charting after a call goes uncounted
  • Patients who were three minutes short of a threshold are invisible until the month closes

Consent that was never recorded

  • A verbal yes on a call that never made it into a field anyone can audit
  • Consent captured for one program, then assumed for the next
  • No way to see, across a panel, who is enrolled but not billable

Documentation that won't survive audit

  • Care plans written once and never revisited against the code's requirements
  • Notes signed on paper, or with a signature that can't be tied to a version of the document
  • No immutable record of who accessed what, and when
Program Coverage

Which CMS programs does the software cover?

Eight: chronic care management, principal care management, advanced primary care management, remote patient monitoring, annual wellness visits, transitional care management, comprehensive medication management, and behavioral health integration. Each has its own purpose-built workflow, and 23 CPT and HCPCS codes are auto-qualified. Each CMS program has its own enrollment rules, documentation requirements, and time thresholds. Praventa ships a purpose-built workflow for all eight, not a generic care plan with the program name changed on it. A patient enrolled in three programs is still one chart, one timeline, and one set of medications.

8CMS Programs

Dedicated workflows, not one template renamed eight times.

23Codes Auto-Qualified

CPT and HCPCS, each with its own minimum-minutes rule and required elements.

1Chart Per Patient

Regardless of how many programs that patient is enrolled in.

ProgramWhat the platform runsCodes

Chronic Care Management

Enrollment, consent, care plan with goal trajectory, monthly time qualification, complex-CCM escalation

99490 · 99439
99487 · 99489

Principal Care Management

Single-condition care plan, CCM-to-PCM transition logic

99426

Advanced Primary Care Management

Tiered enrollment, conflict detection against CCM in the same month

G0556 · G0557
G0558

Remote Patient Monitoring

Device assignment, reading-day tracking, threshold alerts, treatment-management time

99454 · 99457
99458

Annual Wellness Visits

Guided visit wizard, health risk assessment, screening checklist, prevention plan

G0438 · G0439
G0402

Transitional Care Management

AAFP 30-day worksheet, seven steps, auto-determined MDM complexity, face-to-face window tracking

99495 · 99496

Comprehensive Medication Management

Structured pharmacist review, medication therapy problems, adherence scoring, provider letter. Billed on the pharmacist medication therapy management codes.

99605 · 99606
99607

Behavioral Health Integration

PHQ-9 and GAD-7 tracking over time, collaborative care model support

99484 · 99492
99493 · 99494

Code set current as of CY2026. Reimbursement rules and code definitions are set by CMS and change annually.

Praventa patient record showing enrolled programs, active conditions with ICD-10 codes, current medications and recent lab results in one view
One patient, every program they are enrolled in, and the clinical picture behind them in a single record rather than one chart per program. Demo practice with synthetic patient data; direct identifiers blurred.
Time Tracking & Billing

How is staff time tracked and proven?

A timer runs automatically as your staff work in the chart, segmented by activity and attributed to the named employee who did it. Minutes flow straight into CPT qualification, so you can see who has crossed a program threshold before the month closes. Every minute, note, consent, and vital is captured as the work happens, so the claim is a byproduct of care rather than a month-end scramble. A timer starts when your staff opens a patient and segments itself by what they are actually doing: medication review, care plan updates, a phone call, charting after the call. It survives a closed tab, a browser crash, and a mid-shift navigation away.

Automatic activity timer

  • Twelve activity types, segmented automatically as staff move through the chart
  • Persists on pause, stop, navigation, and tab close
  • Session total and running monthly total side by side, with the program's goal marked
  • Manual entry with free-text action taken, for work done off-platform

CPT qualification engine

  • Runs per patient, per program, per billing month
  • Applies each code's own minimum-minutes rule and required elements
  • Flags conflicts, such as CCM and APCM billed in the same month
  • Configurable per practice: which codes are enabled, billing NPI, thresholds

Revenue visibility before month end

  • Dashboard buckets the whole panel by minutes accrued
  • Patients short of threshold are surfaced while there is still time to act
  • Per-staff view of billable versus needs-more-time caseload
  • Superbill generation from the qualified record
1

Your staff work

A coordinator opens the patient and does the work: medication review, a call, a care plan update, charting afterward.

No timer to start
2

Minutes are captured

The timer runs on its own and segments by activity, attributed to the named employee. It survives a closed tab or a crash.

Attributed time log
3

Codes qualify themselves

The engine applies each code's minimum minutes and required elements per patient, per program, per billing month.

Qualified CPT
4

The claim falls out

A superbill is generated from the qualified record, with the signed note, consent and time detail already attached.

Superbill

One record, no re-entry, no reconciliation. Nobody reconstructs minutes at month end, because nobody had to remember them in the first place.

Praventa billing and claims screen showing 80 enrolled patients, CPT qualification status, per-program minutes and estimated reimbursement for the month
Billing and claims before the month closes: every enrolled patient, the programs they are in, the CPT codes that have qualified, the minutes behind each, and the estimated reimbursement. Demo practice with synthetic patient data.
AI Documentation

Does AI write the clinical note, and who signs it?

AI drafts the note; your clinician signs it. Nothing enters the record unsigned, and each signature is bound to a cryptographic hash of the exact document version, so you can prove afterwards whether anything changed. Calls are recorded and transcribed automatically. A structured SOAP note is drafted from the transcript and waits for review. No clinician documentation becomes part of the record without a signature.

SOAP notes from call audio

  • Automatic recording, transcription, and draft generation after every completed call
  • Editor auto-saves every two seconds until the note is signed
  • Signed notes lock, and the signature is bound to that version of the document

Call guides, generated per patient

  • Program-specific talking points built from the patient's actual conditions, medications, and recent vitals
  • Checklists that strike through as the clinician works
  • Newer staff run a competent call on their first day

Provider correspondence

  • Formal letters to the prescribing physician drafted from the medication review
  • Addressed by name, signed by the reviewing pharmacist with credentials
  • Turns a pharmacist's finding into something a physician will actually read

Risk stratification

  • Every patient scored 0–100 from live clinical signals
  • Critical, high, moderate, low, surfaced on the patient list and in the call guide
  • Driven by alerts, worsening conditions, missed readings, and medication problems
Praventa patient record showing a generated CCM call guide beside the care plan and the monthly care plan update panel, with a running task timer in the header
The call guide, the care plan and the month's updates in one frame, with the task timer running in the header. Demo practice with synthetic patient data; direct identifiers blurred.

The scribe itself is covered in depth on AI & Automation.

Patient Engagement

Can our staff call and text patients from the platform?

Yes. Your staff call from the browser with no handset, text two-way from the patient record, and schedule into a shared calendar. Call time counts toward the program total automatically, with no separate entry. Calling, texting, and scheduling happen where the clinical context already is. No separate phone system, no copying a number into a softphone, no untracked outreach.

Voice

  • Click to call from the patient sidebar, in the browser, with no handset
  • Dial the patient or any listed emergency contact from one control
  • Recording, transcription, and note drafting fire automatically on completion
  • Call time counts toward the program's monthly total without a separate entry

Messaging & scheduling

  • Two-way SMS threaded into the patient record
  • Appointment reminders sent automatically before scheduled sessions
  • Calendar defaults to the logged-in clinician's own sessions, with a tenant-wide view one click away
  • Tasks assignable across the care team, tracked to completion
Praventa Voice: automated outreach that books its own appointments. Praventa Voice calls patients for enrollment and check-in outreach, holds the conversation, and books the appointment directly onto the assigned pharmacist's calendar, where it appears alongside every manually scheduled session. The volume problem in care management is outreach, not clinical capacity.
Remote Monitoring & Devices

How does remote monitoring reach our staff?

Cellular devices ship to the patient and pair themselves, with no phone, app or home Wi-Fi required. Readings arrive in seconds, chart individually rather than averaging by day, and breach your per-patient thresholds into an alert your staff sees. Cellular-connected devices ship to the patient and pair themselves. A blood pressure reading taken at the kitchen table is in the chart, charted against history and checked against that patient's thresholds, before the cuff is back in the drawer.

Monitoring

  • Blood pressure, weight, pulse oximetry, blood glucose, temperature
  • No phone, app, or home Wi-Fi required, because the gateway is cellular
  • Thresholds set per patient per vital, not one rule for the whole panel
  • Breaches raise an alert and feed the patient's risk score
  • Every reading charted individually, so same-day readings are never averaged away

Device fleet operations

  • Inventory across every practice, filterable by status
  • Ordering workflow from request through approval, shipment, and delivery
  • Assignment and return tracked per patient with full history
  • Reading-day counts tracked against the RPM billing requirement
Praventa clinical dashboard showing alerts, messages, overdue tasks and per-program detail for comprehensive medication management and chronic care management
The program dashboard: alerts, messages and overdue tasks at the top, then per-program detail with time-tracking distribution and care-plan state. Demo practice with synthetic data.
Software, Not A Service

Can our own staff run these programs?

Yes. Praventa is licensed software your practice runs. Your employed clinical staff deliver every program, your practice bills under its own TIN, and the billing practitioner keeps supervision of every interaction. We never take over your patients and we never bill on your behalf.

What you keep

  • The patient relationship. Your staff make the calls. Nobody from Praventa contacts your patients.
  • The revenue. Your practice bills under its own TIN and rendering NPI, and keeps the reimbursement.
  • Clinical oversight. Every minute is attributed to a named staff member under your supervising practitioner.
  • Your EHR as the system of record. Pull the chart in, push the signed note back.

What you do not have to build

  • A department. Generated call guides and program checklists mean a coordinator, not a specialist, can run the visit correctly.
  • Billing expertise. The engine applies each code's requirements, so nobody memorizes them or defends a guess at audit.
  • A compliance function. Consent capture, audit logging and electronic signatures are in the workflow, not bolted on.
  • A safety net. Every form auto-saves; a closed laptop or a dropped call costs no work.
Running care management for multiple practices? Praventa is multi-tenant, with per-practice configuration, isolation enforced at the database layer, and per-client reporting. That is a different control surface and a different page. See Praventa for care management companies.
Interoperability

Do we have to replace our EHR?

No. Your EHR stays the system of record. Demographics, conditions, medications, allergies and vitals pull in on a schedule, and signed notes push back as clinical documents. Imported records are tagged as such and never overwrite what your clinicians entered by hand. Praventa is not asking you to migrate. Demographics, conditions, medications, allergies, and vitals pull in on a schedule; signed notes push back as clinical documents. Records imported from the EHR are tagged as such and never overwrite what your clinicians entered by hand.

Connect

  • Bidirectional EHR integration: pull the chart, push the signed note
  • Per-practice credentials, stored encrypted
  • Every sync logged with success, failure, and record counts
  • Bulk patient import for onboarding a new practice

Standards

  • FHIR R4 export for downstream analytics and HIE participation
  • CDS Hooks 2.0, surfacing Praventa alerts inside the clinician's existing chart at patient view, encounter start, discharge, and order signing
  • A documented ingestion API for pushing patient data from any source system
  • LOINC-coded vitals, ICD-10 coded conditions

Athenahealth is live today. Praventa's integration layer is built to a single canonical standard, so we will integrate with any EHR platform. Tell us yours and we will scope it.

Security & Compliance

Will the documentation hold up in an audit?

That is what it is built for. An append-only audit log covers every change and every sensitive record view, electronic signatures meet 21 CFR Part 11 expectations, and consent is captured per program with method and timestamp. Care management creates a permanent evidentiary record. Praventa treats the audit trail as a first-class feature rather than a logging afterthought.

HIPAA-compliant infrastructure SOC 2 control framework in place AES-256 encryption at rest 21 CFR Part 11 electronic signatures

Protecting the data

  • Protected health information encrypted at rest with AES-256
  • Tenant isolation enforced by the database itself, on every query
  • Automatic session timeout, configurable per practice
  • Role-based permissions across clinical, billing, and administrative staff
  • Patient records are never hard-deleted

Proving what happened

  • Append-only audit log covering every change and every sensitive record view
  • Electronic signatures meeting 21 CFR Part 11 expectations
  • Each signature bound to a cryptographic hash of the exact document version signed
  • One-click verification showing whether a document changed after signing
  • Emergency break-glass access requiring written justification, fully logged

Staying compliant

  • Consent captured per program, per patient, with method and timestamp
  • Panel-wide view of who is enrolled but missing or expiring consent
  • OIG exclusion screening for providers against the federal LEIE list
  • Periodic access review surfacing dormant accounts at 30, 60, and 90 days
Common Questions

Questions practices ask before they start

Is Praventa software, or an outsourced care management service?

Software. You license the platform and your own employed clinical staff deliver the care. Praventa does not contact your patients, does not staff your program, and does not bill Medicare on your behalf. Your practice bills under its own TIN and rendering NPI, and keeps the reimbursement.

Can our existing staff run care management, or do we need to hire specialists?

Existing staff, in most cases. The platform generates a patient-specific call guide for each program, so a care coordinator rather than a specialist can run the visit correctly. The CPT qualification engine applies each code's requirements, so nobody has to memorize thresholds or defend a judgment call at audit.

Do our clinical staff have to work on-site?

No. Staff can work remotely and their time still counts, provided they are employees of the practice, working under the general supervision of the billing practitioner. The platform attributes every minute to the named staff member and records the supervising practitioner alongside it.

How does the platform prove the time we billed?

A timer starts when staff open a patient and segments itself by activity: medication review, care plan work, a call, charting afterward. It survives a closed tab or a browser crash. Every entry is attributed to a named employee, timestamped, and written to an append-only audit log.

Which programs and codes are supported?

Eight CMS programs with 23 auto-qualified codes: CCM (99490, 99439, 99487, 99489), PCM (99426), APCM (G0556, G0557, G0558), RPM (99454, 99457, 99458), AWV (G0438, G0439, G0402), TCM (99495, 99496), CMM (99605, 99606, 99607) and BHI (99484, 99492, 99493, 99494). Code set current as of CY2026. Note that CPT titles 99605 to 99607 medication therapy management; they are the billing route for pharmacist-delivered comprehensive medication management, which is the broader service.

Do we have to replace our EHR?

No. Your EHR remains the system of record. Praventa pulls demographics, conditions, medications, allergies and vitals on a schedule and pushes signed notes back as clinical documents. Athenahealth is live today; the integration layer is built to a single canonical standard, so other platforms can be scoped on request.

How long does it take to go live?

Onboarding covers bulk patient import, per-practice program enablement, billing configuration and role-scoped user invitations. Start with one program and enable the rest when you are ready, rather than turning everything on at once.

See it run on your own panel

We will walk through the programs you are running today, show where the billable minutes are going missing, and model what the platform recovers. Bring your hardest program.

Request a Demo Talk With Our Clinical Team →