Episode Of Care Manager

Important: Contact your PM Support Representative before attempting to utilize this feature.

Episode of Care (EoC) is an ID either generated by the EHR or the PM that is used to group the claims of an individual into a grouping. This grouping can then have providers with different roles associated with it over given time periods.

The EoC can either enter the PM system through a charge bridge with the EHR or be generated at claim entry by the PM. This EoC ID appears in the other information section of the claim. Once a claim is associated with an EoC ID, the user can go to Support>Management>Episode of Care to manage aspects about this EoC.

If the time period covered by an EoC is shortened, the claims outside of the time range will be disassociated with the EoC ID. If the time range is expanded, then the claims for the patient not currently associated with an EoC ID will be pulled in. EoC providers stop and start date are clipped to the EoC dates. The current reporting method is located under Reports>Revenue Analysis>Provider Productivity. Select the criteria and turn on the option: Source Provider from Episode Of Care: by selecting “Yes”. The “Yes” option will cause the report to substitute the claim provider with the Supervising Provider from the Episode of Care.