01
For the patient.
A pharmacist in their corner between appointments. Monthly check-ins catch problems early, close gaps in care, and help your patients stay on track.
Pharmacist-led care between visits
Quality care between visits.
A clinical partner that extends the work prescribers and practices are already doing well. Pharmacist-led CCM, RPM, APCM, TCM, BHI, and annual wellness visits, delivered by clinicians who know the patients by name.
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Six Medicare programs, one team
Every touchpoint between visits, handled.
Your patients qualify for more between-visit care than most practices can staff. Torch runs the programs end-to-end and routes the clinical decisions back to you when necessary.
CPT 99490
Chronic Care
CCM
Monthly follow-up for patients with 2+ chronic conditions.
CPT 99457Remote Monitoring
RPM
Device-driven check-ins for BP, glucose, weight, SpO₂.
HCPCS G0556–58Advanced Primary Care
APCM
Monthly attribution-based management for complex patients.
CPT 99495/96Transitions of Care
TCM
First 30 days post-discharge. Meds, follow-up, red flags.
CPT 99484Behavioral Health
BHI
Monthly behavioral health follow-up, integrated into primary care.
HCPCS G0438/39Annual Wellness
AWV
Risk assessment, care-gap close, prevention planning.
02
For the clinic.
Between-visit care without the staffing burden. Your team gets time back, and CCM, RPM, BHI, APCM, TCM, and AWV become a steady, billable line of care.
03
For Torch.
Our pharmacists have the opportunity to practice at the top of their license, doing the long-term, relationship-based care that changes outcomes.
How it works
From contract to first encounter.
There's nothing new for you or your patients to learn. We work behind your existing systems and start reaching patients on your timeline.
01 / Onboard
Learn Your System
We take the time to understand your existing workflow and build around it, so there's no drawn-out integration to manage.
02 / Enroll
Consent and enroll
We obtain and document patient consent to meet compliance requirements, and we enroll on your terms within the rules you set for your practice.
03 / Care
Monthly outreach
A pharmacist calls each enrolled patient to review medications, check in on their conditions, close care gaps, and escalate anything urgent back to you.
04 / Document
Clean, audit-ready notes
Time-stamped notes, billable-minute tracking, and ready-to-submit claim files attached to the supervising provider. Your team stays in command of the chart.
What changes, what doesn't
Your practice stays the center of the relationship.
What stays with the clinic
- 01The patient relationship
- 02Clinical decision-making
- 03Prescribing authority
- 04The supervising provider on the chart
- 05Billing under your providers
What Torch takes off your plate
- 01Monthly call cadence
- 02Medication review and adherence
- 03Care-gap identification
- 04Time-tracking and documentation
- 05Audit-ready claim packaging
Why pharmacists
Three things only a pharmacist-led layer can do.
Clinical review, every month
A pharmacist looks at the full clinical picture: whether each condition is at goal, what the labs show, where therapy could go further, and what's worth changing. You get clear recommendations back when necessary.
- Condition-by-condition review against labs and goals
- Therapy to add, adjust, or stop
- Dosing matched to the patient and their organ function
- Adherence barriers, traced to the cause
Quality measures, closed in the same call
HEDIS, MIPS, and value-based contract gaps come up during that same monthly call. The pharmacist closes what they can and routes the rest to your MA.
- A1c, BP, and LDL gaps addressed
- Annual wellness visits scheduled
- Patient-reported barriers logged
A new revenue line, without new staff
These programs run under your supervision but staffed by our team, so your practice adds billable between-visit care without hiring a single FTE.
- Billing under your practice
- No new staff to hire
- Transparent monthly settlement
What providers say
Don't just take it from us…
“
The Torch pharmacist caught a renal-dosed metformin issue on a patient I'd seen the week before. That's the kind of catch that used to fall through the cracks between visits.
Dr. M. Patel, MD
Family Medicine · Independent practice, NC
“
We tried building CCM in-house twice. The minutes never added up to a clean claim. Torch sends us audit-ready claims and a one-page roll-up. We just sign.
J. Williams, Practice Administrator
Internal Medicine group, GA
“
My patients tell me they like the calls. That's not a sentence I expected to write about a chronic care program.
Dr. K. Nguyen, DO
Primary Care · IM/FM, TX
Quotes are representative; full attribution available on request.
The numbers, plain
What a Torch-supported practice looks like.
Drawn from active engagements; figures vary with panel composition and EHR cleanliness.
73%
Of eligible patients consent on the first outreach call.
−41%
30-day readmissions among enrolled TCM patients vs. baseline.
30 days
From signed contract to first billed encounter.
Methodology · independent-practice cohort · refreshed quarterly · available on request
Twenty minutes is enough to see if Torch fits.
Our team will talk to you about your panel, your EHR, and whether these programs make sense for your practice.