Transitional Care Management

Reinvent and transform the post-acute continuum of care.

Interact with patients during the critical 30-day post discharge period to ensure quality of care.

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Approximately 1 in 5 Medicare beneficiaries in the US are readmitted to the hospital within 30 days of discharge.

Why Choose HealthViewX’s Transitional Care Management?

Our HIPAA compliant cloud-based software application designed specifically for managing patients in care transitions.

Automate your entire care transition workflow - from enrolling the patient, creating the electronic care plan, reconciling medications, scheduling and documenting phone calls to generating reports needed for billing purposes.

How It Works:

Our solution acts as an enabler to schedule face-to-face appointments, extend care remotely, access real time patient-health information through bi-directional integration with EHRs.

An interactive dashboard with access to patient information and various tools for providers to deliver TCM activities efficiently.

During the transition period from an inpatient hospital to the patient's community setting, TCM services generally fall into three categories:

  • Interactive Contact

    This can be made via email, telephone, or face-to-face contact within 2 business days following a patient’s discharge to a community setting
  • Non-face-to-face Services

    Obtaining/reviewing discharge information, connecting with healthcare professionals, education and support for scheduling follow up, treatment regimen adherence and medication management
  • Face-to-face Visits

    Face-to-face visits may also be completed, generally within 7 to 14 days depending on Medical Decision Complexity of the patient being discharged from the hospital

Key Business Benefits:

Here's why your care practice should get started with HealthViewX TCM Solution.

  • Patient Engagement

    Patient Engagement

    Engage with transitional patients efficiently to seal the gaps in healthcare and the loss of potential revenue

  • Reduced Readmissions

    Reduced Readmissions

    CMS regulations can charge penalties for those service providers with high level of readmission rate

  • Secure-Communication-HealthViewX

    Secure Communication

    A secure care orchestration platform for exchanging information between providers for improved care quality

  • Customizable-Workflows-HealthViewX-Transitional-Care-Management

    Customizable Workflows

    Simplify workflow with multiple automation touchpoints for every clinic depending on the requirements

  • Health-Progress-Review-HealthViewX-Transitional-Care-Management

    Health Progress Review

    Providers can monitor patients and review their progress during the 30-day period post discharge seamlessly

  • Dynamic-Data-Reporting-HealthViewX-Transitional-Care-Management

    Dashboard and Reporting

    Get a birds-eye view of every possible metric through a fully customizable analytics dashboard and reporting

Through an efficient TCM program, it is estimated to prevent about 76 percent of the readmissions.

Medicare Transitional Care Management (TCM) Reimbursement Codes

Physicians and qualified healthcare professionals such as certified nurse-midwives (CNMs), clinical nurse specialists (CNSs), nurse practitioners (NPs), and physician assistants (PAs) use current procedural terminology (CPT) codes for billing TCM services.


Learn how our TCM solution can elevate your practice by scheduling a no-obligation demo.

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