Do you know that patients can relapse and be readmitted if they don’t get adequate levels
of aftercare services? This is true and it has happened to many patients. Patients
need intense aftercare services to help
them recover fully.
Transitional care management is
designed for doctors, nonqualifying medical practitioners, and
specialist for the care they give patients who have been discharged from health facilities. Transitional care management is a situation where a doctor takes
care of the patient from the time they are
discharged from the hospital. The care
is typically designed to last for 30 days. Medical practitioners such as
doctors visit the patients and in some
cases, the doctor calls the patient to ask him about his current status.
Transitional care management helps to reduce chances of relapsing and reduce
costs of healthcare delivery.
Patient and provider
qualifications
Before the doctor and the patient to get involved in transitional
care management, they need to have some qualifications.
The provider
qualifications
You should know that there are only certain categories of medical practitioners who are eligible to
provide transitional care management services. The qualified medical
practitioners include certified nurse midwives, nurse practitioners, clinical
nurse specialists, physicians of any specialty and physician’s assistants.
There are some providers who
are not physicians that may qualify to provide this service. The healthcare
service provider is required to make contact with the patient within 48 hours
after discharge. You must use an appropriately certified EHR application or
electronic health records for you to qualify for reimbursements. If you don’t
have EHR, then you cannot get additional
revenue that comes through transitional care management.
Having EHR comes with several advantages whereby you can
take advantage of CMS initiatives such as comprehensive care management, TCM,
and patient-centered medical home.
Patient requirements
The patient must meet some important
requirements for them to be involved in
transitional care management. The patients must be
discharged from a qualifying service setting such as an inpatient acute
care hospital, skilled nursing facility, hospital outpatient observation,
long-term care hospital, inpatient psychiatric hospital and partial
hospitalization.
Billing requirements
for TCM
Doctors, nurses and healthcare practitioners usually get
reimbursed for transitional care management services and for them to be reimbursed, they should have the following
billing requirements.
• They should get
and review the information of the discharged patient.
• They should review any requirements for treatments and
tests and do the required follow up/
• They should
arrange and educate the patient’s relative, beneficiary, and primary caregiver.
• The organization
for the practitioner should establish ties with the local community services
and providers.
• They should
schedule follow-up visits with various providers and services.
• The service
providers must provide face to face visits within one to two weeks and this depends on the complexity of the
situation of the patient.
• The practitioner
should furnish the management and medicine reconciliation by the date they should do the face to face
visit which is mandatory.
Transitional care management is beneficial for both
participating parties and
DocChargeCompany is still working towards improving the service further. The
company seeks to simplify the work of physicians and help them deliver their
best.
DocCharge Web http://doccharge.com/
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