General resources
What does TRC stand for in HEDIS?
Transitions of Care
True or False: We can take documentation that the member or the member’s family notified the member’s PCP or ongoing care provider of the admission or discharge.
False
Who can complete a medication reconciliation?
RN, prescribing practitioner, or clinical pharmacist
True or false: If found exclusions must be reported?
True
When abstracting what are the first two things you should verify in the chart?
Where can you locate the official measure training material?
Education and Training Resource center
How many components are required for RDI
6
Who can complete a compliant PE visit?
Anyone, There are no provider restrictions for Patient engagement
What exclusions apply to TRC
Members who die within the MY and Hospice
True or False: If a member is administratively compliant you should still abstract the data for that numerator?
True - We will abstract All data for numerators found in the medical chart, even if that numerator is admin compliant. (this is a change from last year)
How many rates are reported for TRC?
Four
True or false: Telehealth data is acceptable for all TRC numerators?
False, Telehealth is not acceptable for NIA or RDI
True or False: A phone call counts as patient engagement.
True, if it meets documentation requirements.
True or False - Discharges that occur after 12/01/MY is an automatic Exclusion
False - we need evidence that shows member remained inpatient each month from the original discharge timeframe through 12/01/MY to remove as a Valid Data Error
If you identify an exclusion in a medical record, what is your first step?
Place on hold for supervisor to review
True or False: When abstracting a chart you will be looking for both COA and TRC data?
False, you will only be looking for data for your assigned measure.
What additional documentation do you need to see in order to utilize a faxed Discharge summary for RDI?
There must be evidence of when the documentation was placed in the outpatient medical record.
True or False: A medication reconciliation performed without the member present meets criteria
True
True or False: A TRC member with a discharge date of 12/1 should be excluded?
False, the member must remain inpatient through 12/1 to be excluded.
What must be in your QMRM notes that are copied to rateLIFT?
OP visit found pg # IP info found pg # Custodial Organization - pg #s for OP & IP
What major clarification was added to the MRP indicator in MY2025?
Examples of what is NOT considered evidence that the provider was aware of hospitalization or discharge.
If an inpatient stay is preceded by an observation stay, which admit date should be used?
The admit date from the acute or nonacute inpatient stay.
True or False: Any one of these meet MRP. Documentation of “post-op/surgery follow-up.” Documentation only of a procedure that is typically inpatient (e.g. open-heart surgery). or Documentation indicating that the visit was with the same provider who admitted the member or who performed the surgery.
False - without a reference to “hospitalization,” “admission” or “inpatient stay” these are not considered evidence that the provider was aware of the member’s hospitalization or discharge
True or False: TRC members who reside in an Assisted Living facility through 12/1 should be excluded?
False, assisted living is not considered an acute inpatient facility.
What are the three things you need to complete before saving your data entry when abstracting in rateLIFT?
Enter notes
Select abstracted in vendor system check box
select an OR type