Five Key Elements of Transitional Care

Transition care services act as a bridge between the healthcare unit and a patient’s home, where they are likely to receive assistance from healthcare professionals. The essence of TCM is that a healthcare provider takes charge of a patient’s care right from the time they have been discharged. For an efficient transitional care, it is important to consider the five key elements that play a major role. What are those? Let’s have a look.

Medication Management

Documenting and reconciling with medication during discharge should always be documented. The person reviewing the medication can be anyone with the required qualifications to make initial contact. Documentation should include lists of the medication as well as the qualification of the reviewer and any further actions taken, such as the new medication orders.

Face-to-Face Visit

Within the first 7 days following the discharge, the qualified healthcare professional must visit the patient in person. The visit must be documented in detail.

Initial Contact

It is important that a qualified professional contacts the patient or their caregiver within the first two business days following the hospital discharge. The contact between both parties must be documented in detail, including the date and time of contact, the contact’s name, the contract’s process, and a whole summary of the contact.

Decision-Making Level

Following up a 30 days discharge period, transition care management provider requires certain levels of decision-making. But, depending on the code, medical decision-making varies from moderate to highly complex environments. Code 99495 is the moderate complexity of medical decision making, while code 99496 stands for the high complexity of medical decision making.

Non-Face-to-Face Interactions

Though there are no specific number of non-face-to-face interactions or amount of time spent on providing transition care management services, they are an important part of transitional care. Each non-face-to-face service must be documented with the proper date and time and the credentials of the person providing the service.

Final Words

To help patients get back to the community after getting discharged from a hospital, transitional care is important. If you want to manage the transitional care you are providing your patients, get in touch with us.