Medicare AdvantageDocumentationMedium impact
Supporting the HEDIS Transitions of Care Measure
Florida Blue·FL · Family Medicine, Internal Medicine, General Practice +1 more·Quality Measures
Effective date
Oct 1, 2025
We identified it
Jun 16, 2026
Summary
Florida Blue has launched a new PCP Notification tool in Availity Essentials and is emphasizing compliance with HEDIS Transitions of Care (TRC) measure requirements. Primary care providers must now document specific admission/discharge notifications, patient engagement, and medication reconciliation within specified timeframes to meet quality measures.
Action Required
Immediately: Primary care providers must implement documentation workflows for HEDIS TRC compliance: 1) Document admission notifications with date stamps within 3 days of patient admission, 2) Document discharge notifications with date stamps within 3 days of discharge including provider info, procedures, medications, and test results, 3) Document all patient engagement activities within 30 days post-discharge (excluding discharge day), 4) Complete and document medication reconciliation within 30 days of discharge by qualified clinical staff. Access the new PCP Notification tool in Availity Essentials for ADT hospital event updates.