TCM Confusion

eharloff

Contributor
Messages
12
Location
Grand Rapids, Michigan
Best answers
0
For TCM, our Care Manager is under the impression that if a patient is seen within 48 hours of their discharge, we do NOT need to make a phone call prior to the TCM since their appointment is within those 2 business days. Is this accurate or does she still need to call the patient for the initial contact to bill the TCM?

Thanks in advance!
 

lgardner

Networker
Messages
72
Location
Tucson, AZ
Best answers
0
if the patient is seen within 2 business days after discharge, it can, absolutely be counted as "first contact". the same things that would be discussed in the phone call should be discussed at the visit.

this is from the CMS MLN booklet about TCMs:
AN INTERACTIVE CONTACT
An interactive contact must be made with the beneficiary
and/or caregiver, as appropriate, within 2 business days
following the beneficiary’s discharge to the community
setting. The contact may be via telephone, email, or
face-to-face.
 

OpenClaims

Expert
Messages
337
Location
Miami, FL
Best answers
0
This is correct. If the patient is seen by the provider within 48 hours of discharge, then that would count as the TOC IP Outreach.
 
Top