Discharge Outreach Program
Post discharge follow-up care from Capital BlueCross
Our Discharge Outreach Call (DOC) Program is a care outreach program being offered to all members whose benefits include Pre-Certification/Pre-Authorization. This program facilitates access and coordination of post discharge services as necessary.
The DOC Program begins with a member interview within 48 hours after discharge from a hospital and includes self-care, schedule of medications, access to care issues, and equipment/supplies as required.
Members who may benefit from the program are identified by their discharge diagnosis and risk for readmission. Members at risk include those with:
- Complex discharge plan and follow-up needs.
- A history of readmissions.
- A history of frequent emergency use.
The DOC Nurse sends the member general health education information as well as refers members for long-term monitoring or continued assistance when appropriate.