Medicare AdvantageDocumentationMedium impact
Hints for HEDIS® (and more)
Blue Cross Blue Shield of Rhode Island·RI·Physician
Effective date
Apr 1, 2019
We identified it
Jun 20, 2026
Summary
This policy provides guidance on HEDIS Transitions of Care (TRC) measures for Medicare members, requiring specific documentation workflows when patients are discharged from inpatient facilities. While primarily focused on Medicare, practices should follow the same workflow for all patients to ensure quality care coordination.
Action Required
Immediately: Implement TRC documentation workflow for all patient discharges from inpatient facilities. Staff must scan hospital notifications into medical records with receipt dates within 1 day of admission and discharge. Ensure discharge information includes practitioner details, procedures, diagnoses, medications, test results, and care instructions. Schedule patient engagement (office visits, home visits, or telehealth) within 30 days post-discharge. Front desk and clinical staff must update EMR templates to track these requirements for HEDIS quality reporting.