In today’s evolving healthcare landscape, seamless transitions between care settings are essential to prevent avoidable complications and hospital readmissions. Transitional Care Management (TCM) plays a critical role in bridging this gap—especially for patients recently discharged from hospitals, skilled nursing facilities, or similar settings. At Merit Evexia, we offer a turnkey TCM solution that ensures patients receive the support they need during this crucial recovery phase, while helping providers stay compliant and increase revenue.
What is Transitional Care Management?
TCM refers to the coordinated care provided to a patient for 30 days following a discharge from an inpatient facility. These patients are often at high risk for readmission due to complex medical needs or inadequate follow-up. TCM services include initial contact within two business days of discharge, medication reconciliation, and a face-to-face visit within 7 or 14 days depending on the patient’s condition. The goal is to ensure that recovery stays on track and no details fall through the cracks.
How Merit Evexia Supports TCM
Merit Evexia simplifies and strengthens the TCM process for healthcare practices. Our dedicated team reaches out to discharged patients within 48 hours, ensures medication instructions are clearly understood, identifies red flags early, and coordinates the necessary follow-up appointments. All interactions are carefully documented in accordance with CMS guidelines, and billing is handled seamlessly to ensure maximum reimbursement for providers.
We act as an extension of your care team—allowing you to maintain compliance, deliver high-quality follow-up care, and reduce hospital readmission rates without overburdening your in-house staff.
Why TCM is a Win-Win
For providers, TCM services not only improve patient outcomes but also open the door to higher reimbursement opportunities under value-based care models. For patients, TCM offers reassurance, clear guidance, and proactive attention at a time when they need it most. With Merit Evexia, the transition from hospital to home becomes safer, smoother, and smarter.
