CSMS-IPA Resources for Transitional Care Management

CSMS-IPA Cigna Toolkit – Care Transitions Section ( available on the CSMS-IPA website (CSMS-IPA sign on required to access)

• Contains practical tools, scripts and checklists for post discharge calls, visits, readmission reduction and patient handouts. Pages 12-23.

Other Resources – Available on the CSMS-IPA website (no password access required)

• Effective Post-Discharge Transitional Care Management (CSMS-IPA Webinar, June, 2020) slides
• Carescreen Overview of Transitions of Care
• CMS Transitional Care Management Services
• CMS Telehealth in Post Discharge Follow Up
• CMS Guide to Reducing Disparities in Readmissions
• ER Decision Guide for Patients (CSMS-IPA)
• FAQ on TCM Coding – AAFP
• Medication Reconciliation Post Discharge Tip Sheet