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Transition of Care and new CMS ruling.

MU, CQR, PQRS, etc.

Last Post by Anonymous 1 second ago

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dorotheatrusty

(@dorotheatrusty)

Posts: 148

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Topic starter

Can someone weigh in on this for me? Is anyone using Qvera Interface Engine for their transition of care? Also with the new CMS ruling what changes have you made? What is defined as a TOC?

Thanks.. UGH!

Posted : November 10, 2015 6:31 am

bruins1986

(@bruins1986)

Posts: 233

Reputable Member

Hi,

We are using Qvera for transition of care and I love it - I'd be happy to answer any questions you may have.

We have not made any changes since the ruling but we were "all in" on the new rules when they were proposed back in April (meaning we already weren't doing the manual generation and print process).

Effectively, we define a TOC as any ordered movement by a provider of a patient for care of their condition to another (external) provider of care. Referrals are an easy example but, for instance, if a specialist were to order a patient back to their PCP for continued monitoring and/or care of the condition they saw them for we'd consider that a TOC as well. But the TOC part (separated from the referral part) is certainly up to interpretation - my suggestion is write a definition, get it approved by the providers and keep it in the audit packet for CMS. CMS does give some wiggle room with the definition, you'll just want a policy written and consistent adherence to said policy/definition (in my humble opinion anyway).

Thanks

Mike

Posted : November 10, 2015 7:09 am

dorotheatrusty

(@dorotheatrusty)

Posts: 148

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Topic starter

We are not currently transmitting our Referrals electronically. It's a manual process but we want to use Qvera. Also, are you also specifying the TOC in the office in your workflows?

Posted : November 10, 2015 7:19 am

bruins1986

(@bruins1986)

Posts: 233

Reputable Member

What do you mean by "specifying the TOC in the office in your workflows"?
I would suggest reaching out to Qvera (or kryptic if you want to investigate the portal route) ASAP since it will take some time to get up and connected.

Posted : November 10, 2015 7:53 am

dorotheatrusty

(@dorotheatrusty)

Posts: 148

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Topic starter

Basically the referrals to outside providers.

Posted : November 10, 2015 9:41 am

DVI1501

(@dvi1501)

Posts: 80

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Bruins1986 - What HISP are you using through QVERA?

Posted : November 11, 2015 10:19 am

bruins1986

(@bruins1986)

Posts: 233

Reputable Member

We are located in Massachusetts so we are connected to the Mass HIWay.

Posted : November 11, 2015 10:22 am

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