Notification of Inpatient Admission
Documentation must show that the receipt of admission notification was received by....
What is... On the day of admission through 2 days after admission
Documentation must include evidence that the receipt of discharge information was received by when?
What is…
On the day of discharge through 2 days after discharge
Patient Engagement can occur in what type of setting …
List at least 3
What are..
•Office visits
•Home visits
•Telehealth
•Home health
•Patient portal
•Phone call
•Text messaging
The time frame in which medication reconciliation post discharge can be conducted?
What is…
On the date of discharge or within 30 days after discharge (31 total days)
Statement "Post Op Surgery" alone
What is....
Does not imply there was an hospitalization
Documentation that the PCP ordered tests or consulted with the member anytime during the inpatient stay OR PCP received notification of planned admit OR performed a pre-admit exam on the member
What are.... 2 exceptions of Notification of Admission
The number of required components that must be present in the outpatient record to be acceptable for Receipt of Discharge
What are… 6 Required Components
The day after discharge and within 30 days of discharge.
What is….
Time frame for patient engagement after discharge.
Individuals able to conduct a Medication Reconciliation Post Discharge?
Who are…
A prescribing practitioner (Physician, PA, ARNP), Clinical Pharmacists or Registered Nurse
HEDIS was established by....
What is...
The National Committee for Quality Assurance (NCQA)
Documentation that...PCP was notified of ER Visit, Family member notified PCP of admission, Provider sent the member to the ED, Documentation does not include a date
What are...Examples of unacceptable documentation from notification of inpatient admission
The last acceptable date of service for a discharge to occur in 2022
What is…. December 1, 2022
Interaction with this staff member meets the requirement for patient engagement as long as it is documented in the medical record and occurs during the required timeframe.
Who is…
ANY Staff Member
Facilities that are acceptable for reference to hospitalization / inpatient stay, when performing Medication Reconciliation Post Discharge?
What is….
A Hospital, Inpatient Rehab Facility, or Nursing Home/Skilled Nursing Facility
Hospice & Not discharged to an outpatient setting on or before December 1
What are....
Required Exclusions