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Principal Care Management

Dedicated monthly support for one high-risk condition.

PCM is built for patients with a single serious chronic condition who need more than episodic care — without the complexity of a full multi-condition CCM panel.

Program at a glance

High-risk condition
1
Monthly care time
30+ min
Monthly program
Billable

What it is

Principal Care Management (PCM) provides focused, non-face-to-face care coordination for patients with one high-risk chronic condition that requires frequent adjustment and close follow-up. Synexa implements PCM with condition-specific care plans, monthly outreach, specialist coordination when needed, and billing-ready documentation — helping your clinic support complex patients who often fall through the cracks between visits.

Clinical benefits

  • Targeted support for one serious condition — e.g. uncontrolled diabetes or advanced CKD
  • Appropriate for patients who don't qualify for CCM but still need structured follow-up
  • Reduced care gaps and improved adherence for high-utilization patients
  • Billable monthly program with clear time and activity documentation

Who it's for

Built to plug into a wide range of clinic types and care models.

Primary careInternal medicineFamily medicineMulti-site clinicsValue-based / ACO practicesFQHCs & RHCs

How it works

A fully managed rollout — we handle the operations so your clinic captures the clinical and financial benefits.

  1. 1

    Identify & enroll

    We help flag eligible patients across your panel and handle the enrollment outreach.

  2. 2

    Deploy & train

    Equipment, technicians, and workflows are set up inside your clinic — without disruption.

  3. 3

    Deliver in-workflow

    Testing or ongoing care happens within your existing visit flow, not around it.

  4. 4

    Report & bill

    Specialist reports return to the chart and we coordinate clean, compliant billing.

What's included

Everything needed to run the program end-to-end — bundled into one turnkey partnership.

Equipment Provided

We supply, deploy, and maintain all required testing devices on-site at your clinic.

Trained Technicians

Our certified technicians perform the testing so your clinical staff stays focused on patient care.

Specialist Interpretation

Board-certified specialists interpret every study and return clear, actionable reports.

Billing Coordination

We help coordinate billing workflows so the program runs as a clean revenue stream.

Frequently asked questions

The details clinics ask about most before getting started.

How is PCM different from CCM?

PCM focuses on a single serious chronic condition that needs frequent adjustment, whereas CCM covers patients with two or more chronic conditions. PCM fills the gap for complex single-condition patients.

Who is PCM for?

Patients with one high-risk condition — for example uncontrolled diabetes or advanced CKD — who don't qualify for CCM but still need structured monthly follow-up.

Who provides the monthly care?

Synexa's care team delivers condition-specific outreach, care plan upkeep, and specialist coordination under your providers' direction.

Is PCM reimbursable?

Yes. PCM is a billable monthly program with clear time and activity documentation, which we capture for compliant claims.

Ready to add preventive care programs to your practice?

Schedule a no-obligation walkthrough with our team. We'll show you how Synexa fits your clinic in 20 minutes.