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Blue Cross Blue Shield of Rhode IslandMedicare Advantage · Documentation · Physician · RIMedium impact

Hints for HEDIS® (and more)

Act
immediately
Effective date
Apr 1, 2019
Identified
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.

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What to do

immediately · 5 steps
01Implement TRC documentation workflow for all patient discharges from inpatient facilities.
02Staff must scan hospital notifications into medical records with receipt dates within 1 day of admission and discharge.
03Ensure discharge information includes practitioner details, procedures, diagnoses, medications, test results, and care instructions.
04Schedule patient engagement (office visits, home visits, or telehealth) within 30 days post-discharge.
05Front desk and clinical staff must update EMR templates to track these requirements for HEDIS quality reporting.

Original notice

Hints for HEDIS® (and more)
bcbsri.com · Always check the source before changing claims.
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Related changes

See all Blue Cross Blue Shield of Rhode Island changes →
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