Transitional Care Management

Help high-risk patients stay out of the hospital

ThoroughCare is an end-to-end solution for Transitional Care Management.

Track and report hospital discharges, coordinate patient transitional care services, meet Medicare's rules and requirements and simplify reimbursement.

A comprehensive platform to optimize care delivery

Manage transitions of care with tools to track and report discharge activities, document patient communication, and close gaps in care.

Coordinate time-sensitive service requirements using near real-time ADT alerts

Create and share discharge reports to inform decision-makers every step of the way

Simplify CPT codes and billing with an audit trail to capture reimbursement


An intuitive workflow to support patient care transitions

Leverage patient and provider data within a comprehensive care platform

ThoroughCare connects with electronic health records, data exchanges, remote monitoring devices, and mobile applications — for an inclusive patient view.

Inform stakeholders at every stage

Share discharge reports that outline every stage of a patient's transition. Use reports to support billing claims for TCM and capture reimbursement.

Anticipate discharge date and location

Focus on up and coming discharges within specific care settings.

Track patients' transitions

Document calls with patients to support workflow and keep all members of the care team informed.

Manage medications at a critical time

Capture medication information to better engage patients on adherence.

Simplify billing

Automatically assign Transitional Care Management CPT codes, including 99495 and 99496.

Learn more about Transitional Care Management

Rules and requirements of TCM

Understand provider expectations, service requirements, and the billing process for a successful program.

TCM tech for safety and cost control

Safe, efficient patient transitions are critical to ensuring continuity of care and reducing the chance of a hospital readmission.

Successful transitions support value-based care

TCM can add value by helping patients navigate the healthcare system after a hospital discharge.