decisionhealth Newsletters, Part B News - 2013 Issue 1 (January)
Choose established patients, friendly hospitals to earn new revenue with TCM codes
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Article Overview
This article explains transitional care management (TCM) as a revenue opportunity for physicians and non-physician practitioners, with a focus on operational steps for identifying eligible patients, coordinating with hospitals, and managing post-discharge workflows. It is aimed at practices, billers, coders, and administrators who need a broad understanding of how TCM fits into existing patient relationships, documentation timelines, and clinical follow-up processes.
Why This Topic Matters
TCM billing can create new reimbursement opportunities, but success depends on coordinating discharge information, patient contact, and follow-up within required timeframes. The article helps practices understand the operational burden and the kind of internal and hospital relationships needed to support compliant billing.
Article Sections
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Transitional Care
Introduces TCM billing as a practice opportunity and discusses who may bill and the general context for post-discharge care coordination.
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Make friends with hospitals
Describes how practices work with hospitals to identify discharged patients, obtain discharge information, and organize follow-up processes.
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Start with familiar faces
Focuses on the practical emphasis on established patients and the role of existing provider relationships in TCM workflow.
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Get the patient in ASAP
Covers the workload involved in transitional care follow-up and the staffing and timing considerations involved in post-discharge management.
What You Will Learn
- How transitional care management fits into practice revenue strategy
- Why hospitals can be important partners in post-discharge workflow
- What kinds of practice operations support TCM follow-up
- Why established patients are often the starting point for TCM efforts
- How timing and staffing affect the ability to support transitional care services
Who Should Read This
- Physicians
- Specialists
- Non-physician practitioners
- Medical coders
- Billing staff
- Practice administrators
- Revenue cycle managers
Codes Discussed
Code Ranges Discussed
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