Post-Discharge Outreach
APPs initiate patient contact within 48 hours of discharge to assess risk, review medications, and ensure follow-up appointments are scheduled.
PsynergyHealth’s Advanced Practice Provider programs range from in-patient virtual support, full service 24/7 virtual urgent care programs, and part-time CCM support.
Transitional Care Management (TCM) supports patients after discharge through timely follow-up and coordinated care to reduce read missions and improve continuity of care. Delivered by Advanced Practice Providers—including Nurse Practitioners and Physician Assistants—TCM focuses on post-discharge evaluation, medication management, and care transition planning within established clinical protocols.
Our virtual Transitional Care Management program extends clinical capacity through TCM-trained Advanced Practice Providers, enabling consistent post-discharge follow-up, coordinated care transitions, and improved outcomes—without adding burden to on-site teams or health system overhead.
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The health system/hospital bills for all services, PsynergyHealth works on retainer models monthly.
No! PsynergyHealth’s software partner, Andor Health, provides their technology as part of the clinical service agreement that we bring to the table.
Bringing on physician resources to augment in-person clinical teams at a more efficient and effective price point for the health system.
Partner with a dedicated team focused on elevating your patient experience.
You’re one step closer to getting the support you deserve. Our team will contact you shortly to review your eligibility and answer any questions you may have.
Find out if you're eligible for Psynergy Health's care program. Our team will review your information and reach out to discuss your options.
You may qualify if you have Original Medicare (Part B) and live with one of the conditions above, such as high blood pressure, diabetes, ongoing joint or back pain, or depression or anxiety. Not sure? Call [ENROLLMENT PHONE NUMBER] and a real person will help you find out. It is free to call.