Care coordination agreements that promote improvements in patient tracking across settings

Establish effective care coordination and active referral management that could include one or more of the following:

Validation

Functionality of effective care coordination and referral management

Suggested Documentation

1) Care Coordination Agreements - Sample of care coordination agreements with frequently used consultant that establish documented flow of information and provides patients with information to set consistent expectations; or
2) Tracking of Patient Referrals to Specialists - Medical record or EHR documentation demonstrating tracking of patients referred to specialists through the entire process; or
3) Referral Information Integrated into the Plan of Care - Samples of specialist referral information systematically integrated into the plan of care

2024 MIPS by Specialty