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Overview
This article provides in-depth explanation on automated workflows available through ThoroughCare's Transitional Care Management program that allows users to easily limit clicks and track progress. Using TCM billing requirements, users can perform and update their patient's Initial Communication and Face-to-Face Visit interactions
Communication Overview & Eligibility Status Updates
TCM's Communication Overview has been redesigned to help users more easily track the status of their patient's discharges. Still separated into Initial Communication and Face-to-Face Visit sections, this area of the TCM record will always show an up-to-date record of both communication requirements so that there is no question as to if visits have been scheduled or if they were performed in the necessary timeframes by displaying each requirement's current status, due date (if applicable), scheduled and logged calls, and additional updates as needed.
Initial Communication Statuses
Not Available: This status will display when a discharge record is created with only an anticipated discharge date. The Communication Overview will not begin tracking communication attempts until an official discharge date is entered
Due: If the record has a discharge date, and the current date is within 2 business days of that date, the Initial Communication area will display the date that the communication must occur for the TCM to remain eligible.
As users begin scheduling and logging calls through either the Calendar or the Initial Communication - 'Interactive Contact' section, the call records will begin populating in the overview (up to 2).
Completed: If the Initial Communication requirement is met through at least one successful call or two unsuccessful call attempts within the 2 business days, the TCM will remain eligible for billing.
Once both the Initial Communication is 'Completed' and the required 'Discharged to' field is entered, the Initial Communication To Do will be automatically set to 'Completed' as well.
Deadline Passed: If the Initial Communication requirement is not met within 2 business days, the status will update to Deadline Passed.
Once the deadline has passed, the TCM's Eligibility status will be automatically updated to Non-Eligible.
If the required communication occurred within the necessary time frame but was not documented in time, users can always enter their backdated call records. If the requirement is met through this workflow, the TCM's Eligibility status will automatically reset to Eligible and the Communication Overview will update accordingly.
Face-to-Face Visit Statuses
Not Available: This status will display when a discharge record is created with only an anticipated discharge date. The Communication Overview will not begin tracking communication attempts until an official discharge date is entered.
Due: If the record has a discharge date, and the current date is within 7 or 14 calendar days (based on the TCM's documented 'Complexity') of that date, the Face-to-Face Visit area will display the date that the visit must occur by for the TCM to remain eligible.
As users begin scheduling and logging visits through either the Calendar or the Face-to-Face Visit/Finalize - 'Visited at' field, the visit records will begin populating in the overview (up to 2).
Completed: If the Face-to-Face Visit requirement is met within 7 or 14 calendar days, the TCM will remain eligible for billing.
Deadline Passed: If the Face-to-Face Visit communication requirement is not met within the necessary 7 or 14 business days, the status will update to Deadline Passed.
Once the deadline has passed, the TCM's Eligibility status will be automatically updated to Non-Eligible.
If the required visit occurred within the necessary time frame but was not documented in time, users can always enter their backdated records. If the requirement is met through this workflow, the TCM's Eligibility status will automatically reset to Eligible and the Communication Overview will update accordingly.
Creating Automated Calendar Interactions
Users can now schedule and log their TCM-related interactions without ever having to enter their patient's Discharge records. To do so, they can create a call record from the Calendar and associate it with any Call Purpose associated with the TCM product.
As long as the interaction's 'Start' date occurs during the same timeframe that the patient has an open transition record, the interaction will populate as 'Scheduled' in the Communication Overview. Once the interaction is logged with either a 'Successful' or Unsuccessful' outcome, the transition will begin counting that call towards the communication requirement.
Note: In the example shown below, 'Reached' would be considered a successful outcome and the rest of the outcome options would be considered unsuccessful.
After a TCM meets its Initial Communication requirement, a user can also create Face-to-Face Visits through the Calendar by setting the 'Type' to 'Video'.
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