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Lumata HealthLumata Health
  • Services
    • Overview
    • Care Management
  • About Us
    • Team
    • Advisors
  • Patients
  • News
  • Careers
  • Contact Us

Generate revenue with between-visit care management

Lumata Health is the first and only company providing care coordination and counseling for patients with chronic eye conditions. We help patients effectively manage their care when they’re not in your clinic.  We also improve the efficiency of your clinic by reducing inbound phone calls and time spent on non-clinical tasks, reducing no shows and cancellations, and reducing ophthalmic technician and assistant workload – all while generating revenue and improving outcomes, patient satisfaction, and quality of life. Our team of experienced and certified ophthalmic technicians and assistants currently serve patients with glaucoma, diabetic retinopathy, macular degeneration, and chronic dry eye. With an average of 12 years of in-clinic experience and specialized training in social work, case management, and motivational interviewing, our care coordinators are experts at helping patients that need it the most.
In addition to promoting compliance, we can help patients with things like:
  • Financial assistance programs
  • Prescriptions and refills
  • Insurance issues
  • Transportation to visits
  • Understanding their disease and care plan
  • Coordinating care with other providers

Why 90% of providers we engage sign up for care management

Reduced Staff Workload

Our care coordinators spend an average of 5 hours a year with each enrolled patient, freeing up valuable time for your in-clinic staff.

Revenue-generating

The care management services we provide are reimbursable using Principal Care Management Codes, adding net profit to the practice.

Improved Outcomes

Patients love the concierge level of service and are more compliant as a result of the support they receive.

Increased Visit Efficiency

Educated, adherent patients improves the quality of patient visits and reduces chair time. We reduce no-shows 30% on average and up to 3x in some practices.

What patients are saying about their care coordinator

I will always remember the help I received. I never would have known that the wavy lines were so serious. The Care Coordinator got me worked in to be seen by the doctor so I could begin treatment sooner.

82 year-old
AMD Patient

After our last call, I tried some of your suggestions for my diet. Since then I’ve seen improvement in my blood sugar and I’ve lost seven pounds. I’m so thankful for the call today and look forward to speaking again.

68 year-old
DR Patient

The Care Coordinator called me right when I was having pressure and pain just like I had before my iridotomies. She got me an appointment on the same day and we found that my pressure was up to 37. The doctor started me on drops. What a relief.

73 year-old
Glaucoma Patient

My eye drops were always running out before the prescription could be refilled, so much was wasted. My Care Coordinator sent me a NanoDropper and I see a significant reduction in waste. My pressures are more under control, and I have saved money.

85 year-old
Glaucoma Patient

Frequently Asked Questions

What are the details regarding reimbursement for care management services?

These services qualify for reimbursement through Principal Care Management codes, which were added by Medicare in and 2020 and are due to the success of the Chronic Care Management codes introduced in 2015. These codes, which saw a reimbursement increase of over 50% in 2022, are billed separately from office visits on the date that all criteria for billing have been satisfied. As a result, we guarantee meaningful revenue to practices who offer our services with no startup fees or cumbersome EMR integration required. 

What can Lumata Health do to help my patients?

Care coordinators can do anything that helps the patient better manage their disease. At-home care, medication adherence, and visit attendance are major areas of focus, but we also spend significant time helping patients with things like financial assistance programs, prescriptions and refills, insurance issues, transportation, social services, disease education, and coordinating care with other providers. In all interactions, we counsel the patient using proven behavioral science tools like Motivational Interviewing. Our care coordinators are a trusted, always-available partner in the patient’s care journey. We take great pride in our ability to build deep, long-lasting relationships with patients.

How does Lumata communicate effectively with the practice about patient care?

For non-emergent and non-clinical issues, the primary medium of communication is through the EMR, following the process that in-clinic technicians use to communicate about patient care. If emergent issues arise, the Care Coordinator will transfer the patient directly to the phone number provided by the practice for medical issues (including a “warm” hand-off to clinic staff to bring them up to speed on the patient and the issue). 

A dedicated Clinical Operations / Account Manager and Lead Care Coordinator are assigned to each practice, and are reachable at any time via phone or email.

Are there any recurring fees or startup costs?

No, Lumata Health does not charge any startup costs. There is no penalty to cancel the program. The practice can terminate the agreement at any time.

Why not do this in-house?

For  most practices, offering this service in-house is not financially viable due to the staffing, technology, and oversight required.

Staffing

A typical Care Coordinator requires about 500 patients “under management” to offset the salary and overhead costs associated with providing the service. Fewer patients under management means the practice is operating at a loss. Likewise, 600 patients under management means 100 patients either cannot be helped, or the practice has to hire another person (at a loss) to accommodate those patients. A practice may elect to split a technician’s time between care management and normal duties. This can be ineffective largely because patients require assistance at unpredictable times, or are unreachable when the Care Coordinator is free to contact them. The result is an inefficient process that is difficult to justify financially, frustrating for patients, and likely detrimental to the quality of care. 

Lumata Health makes this work by managing patients for practices all over the country, keeping our Care Coordinators operating at close to 100% capacity across multiple locations and having a team of Care Coordinators available to answer patient calls at any time. Also, our Care Coordinators have a unique skill set – combining their eye care knowledge as a COA or COT with social work and behavioral science knowledge through our training programs. 

Technology

Most practice EMRs are not equipped for care management. They lack specific functionality such as detailed and integrated time-tracking, automated call scheduling, embedded text messaging, automated care plan creation and many more features necessary to operate a successful care management program that satisfies CMS requirements.  Lumata Health has invested heavily in building a custom, HIPAA-compliant platform specifically tailored for care management.

Lastly, our proprietary AI-driven engagement algorithms, built with NEI support, provide a level of efficiency and effectiveness that is difficult to replicate in-house.

Who is actually contacting my patients?

Lumata almost exclusively employs Certified Ophthalmic Technicians or Assistants with prior in-clinic experience. The care team will have the identical certification and training to your current staff. All of our COAs/COTs have worked in an ophthalmology clinic for at least 3 years, though some have decades of experience. We also employ Registered Nurses for special cases, particularly for those patients with diabetic retinopathy who struggle with diabetes control or complex patients dealing with numerous other complex conditions. All clinical staff participate in the same continuing education as in-clinic technicians to improve their skills and maintain their certification. 

Our goal is to develop trust and rapport with the patients in our program. For that reason, each patient will have a single Care Coordinator responsible for helping and guiding them.  Likewise, each practice will have a single “lead” Care Coordinator, as well as a dedicated Account Manager. In most cases, the lead Care Coordinator is the same Care Coordinator responsible for managing all patients at the practice. For large practices, there may be a two or three-person team of Care Coordinators. 

Does every doctor at the practice have to participate?

No, we are willing and able to provide this service to patients of any number of physicians that would like to participate. At some practices, we have started the service with one or two physicians prior to expanding practice-wide.

Is my patient’s data safe with Lumata?

Lumata adheres to the highest standards of data privacy and security for all of our customers, from large insurance providers to individual practices. We are HIPAA compliant, but also operate in HI-TRUST certified environments when appropriate. Our data privacy and security processes and protocols have been rigorously vetted and approved by each of our customers, including Health Care Service Corporation – the largest customer-owned health insurance company in the United States.

How will Lumata and/or the practice know if the program is successful?

Our primary outcome measures are clinical; we expect better clinical outcomes derived from our focus on promoting compliance with the doctor’s recommendations. To date, we have demonstrated statistically significant reduction in intraocular pressure for patients in our program versus a control group. Lumata also uses validated survey instruments to assess the effectiveness of the program at improving self-reported medication adherence. We also track patient experience of their chronic care management, patient satisfaction with their physician/practice, patient satisfaction with Lumata’s service, and patient perceptions related to their unique barriers to care. The validated instruments used are the ASK-12, PACIC, NPS, OSDI, and ABQ-IVT surveys.

Are Lumata Care Coordinators providing clinical advice or answering clinical questions?

No. Our focus is on solving non-clinical problems that prevent patients from adhering to their doctor’s recommendations, such as financial issues, transportation, prescription refills, insurance issues, and general health coaching to promote compliance. We do provide the patient with information related to their doctor’s instructions, such as reminders about which medications they should be taking, and when. This information is based on what is in the patient’s chart. We are happy to share our policies and procedures for dealing with medical issues over the phone. These policies mirror typical in-house clinical staff guidance and are based on JCAHPO training modules.

What happens if a patient wants to leave the program?

A requirement from Medicare is that every patient must be aware that they are able to leave the program at any time. Should a patient decide to cease participation, their disenrollment is documented in the EMR along with the primary reason for unenrollment. Reasons for disenrollment may be a lack of perceived value, patient perception that they are now “in control” of their care, resolution or stability of the chronic condition, or moving or transferring to another physician. If a patient’s care is transferred to another physician, Lumata will assist the patient in making that transition prior to closing the patient’s account.

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