For patients with moderate or high complexity medical issues, the first month after being discharged from an inpatient setting (such as a hospital or a skilled nursing facility) is a critical time frame. In this period of adjusting to community settings, the patient faces the highest risk of readmission due to the existing medical condition …
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source https://practiceforces.com/blog/essentials-of-transitional-care-management-tcm-medical-billing/
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