Platform deploys voice AI agents for patient enrollment, check-ins, compliance documentation, and billing reports; no setup fees or contracts
BETHESDA, MD, UNITED STATES, March 9, 2026 /EINPresswire.com/ — Tile Health, a healthcare technology company focused on primary care revenue cycle automation, today announced the full commercial launch of its Advanced Primary Care Management and Chronic Care Management automation platform for independent primary care practices. The platform uses AI voice agents to automate the patient outreach, monthly check-ins, symptom triage, compliance documentation, and billing report generation that define APCM and CCM programs — allowing practices to capture significant Medicare reimbursement without adding clinical staff.
– Addressing a $40 Billion Untapped Market
CMS introduced the APCM program on January 1, 2025, alongside existing CCM codes that have been available since 2015. Despite a combined addressable reimbursement opportunity estimated at $40 billion annually, fewer than 25,000 of the nation’s approximately 295,000 primary care providers have ever billed a single CCM claim. More than 96 percent of the approximately 23 million eligible Medicare beneficiaries remain unenrolled in any care management program.
The barrier is not reimbursement rates — CMS has raised CCM reimbursements by approximately 50 percent since 2021, with an additional 10 percent increase finalized for 2026. The barrier is the operational infrastructure required to run compliant programs: consistent monthly patient outreach, structured clinical check-ins, precise time-tracking and documentation, and monthly billing report generation. For most independent practices, these requirements exceed the capacity of existing clinical staff.
“Independent primary care practices are sitting on one of the largest unclaimed revenue opportunities in Medicare,” said Alex Frost, Chief Executive Officer of Tile Health. “Our platform removes every operational barrier between a practice and that revenue — the AI handles the calls, the documentation, and the reports. The physician reviews flagged clinical issues and approves care plans. Everything else runs automatically.”
-How the Platform Works
Tile Health’s platform integrates directly with all major EHR systems, including Epic, Oracle Health (formerly Cerner), athenahealth, eClinicalWorks, AdvancedMD, Meditech, ModMed, and NextGen. The integration allows the platform’s Smart Eligibility Engine to automatically identify patients who qualify for CCM and APCM billing based on their diagnoses and Medicare status.
Once eligible patients are identified, the platform’s AI voice agent initiates outreach calls for enrollment, obtaining verbal consent and explaining program benefits in conversational language. After enrollment, the AI conducts monthly wellness check-ins covering medication adherence, symptom reporting, activity levels, and care coordination needs. The system uses real-time clinical logic to detect and escalate red-flag symptoms — chest pain, shortness of breath, falls, mental health crises — to on-call clinical staff immediately.
All interactions are recorded with precise time-stamping, transcribed, and stored with HIPAA-compliant encryption for a minimum of seven years. At the end of each calendar month, the platform generates an audit-ready billing report mapping each patient’s contacts to the appropriate CPT or APCM G-codes, ready for submission through the practice’s existing billing workflow.
-Designed for the 2025 Regulatory Environment
The platform is built to support both legacy CCM billing (CPT codes 99490, 99439, 99491, 99487, and 99489) and the new APCM G-codes (G0556, G0557, and G0558) introduced under the 2025 Medicare Physician Fee Schedule. Practices can run CCM for some patients and APCM for others — the platform tracks billing program enrollment at the patient level to prevent concurrent billing conflicts that would result in claim denial.
The platform also supports the Federally Qualified Health Center and Rural Health Clinic transition away from the all-purpose G0511 code, which CMS has indicated should be completed by October 2025. For these facilities, the platform handles the full transition mapping from G0511 to individual CCM and APCM codes without requiring operational workflow redesign.
Tile Health is HIPAA compliant and SOC 2 certified. All data is encrypted at rest and in transit. A Business Associate Agreement is signed with every partner practice prior to platform activation.
-Commercial Terms and Availability
Tile Health is available to independent primary care practices nationwide with no setup fees and no long-term contracts. The platform is offered under a per-patient monthly fee structure, allowing practices to scale program revenue before committing to platform costs. Practices with 500 or more Medicare patients with chronic conditions — the profile that generates the highest return from automated care management — see the most significant revenue impact in the first 90 days.
According to Tile Health’s internal projections, a practice with 500 eligible Medicare patients achieving 40 percent enrollment generates approximately $254,000 in annual CCM revenue on the platform before stacking with Remote Patient Monitoring or Behavioral Health Integration codes.
Interested practices can learn more and schedule a demonstration at TileHealthcare.com.
-About Tile Health
Tile Health is a USA-based healthcare technology company specializing in AI-powered chronic care management and advanced primary care management automation for independent primary care practices. The company’s platform integrates with all major EHR systems and is designed to convert Medicare’s most underutilized reimbursement programs into reliable, recurring monthly revenue for primary care practices without adding clinical staff. Tile Health is HIPAA compliant and SOC 2 certified.
Ali Elmarsafawy
Tile Health
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