Woodlands’ Chronic Care Management program is designed to help Medicare patients with chronic conditions better manage and control their health. It is our goal with this program to educate patients with chronic conditions, answer questions as they arise, and prevent unnecessary trips to urgent care centers and emergency rooms.

Our physicians and healthcare providers are working together with Medicare to give patients additional covered services outside of their office visit when needed.

Thanks to this new benefit by Medicare, the Chronic Care Management program will enable our team to more easily follow up with patients and coordinate care between office visits. Our program’s key services include;

  • 24 / 7 phone access to a physician in our practice to address acute care needs
  • A personal registered nurse to call you after an office visit to ensure you understand the diagnosis and treatment plan discussed in your visit
  • Direct phone access to your personal nurse for any health related concerns, i.e, medication refills, concerns about medication interactions and acute health problems
  • Management of care transitions, i.e., phone support and pre-office visit care following a discharge from the emergency room, hospital, or nursing home
  • An Annual Wellness Visit to review medications and ensure your preventive care services are up-to-date
  • Follow-up after specialty consultations to ensure your needs have been met and that any tests or studies are completed in a timely manner

If you would like to participate in our Chronic Care Management program, ask your physician if you qualify during your next appointment. Medicare requires that patients have two or more diagnosed chronic conditions. Patients will need to agree and consent to our office billing Medicare for this service on any month that we provide more than twenty minutes of non face-to-face care. Deductible and co-insurance charges will apply. Our office will have a record of our time spent managing your care if you ever have questions about what we did during a given month. You can discontinue this service at any time and for any reason.

Our goal in providing this service is to provide patients with the highest quality and most convenient care possible, to prevent urgent hospital visits, and to minimize inconveniences due to unnecessary healthcare appointments. We know that your time and your health are valuable, and we work to make sure your health needs are addressed and treated.

If you would like more information, please call us at 850-696-4000 or ask your physician during your next visit.




Monday – Friday 8:00a – 5:00p





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