Patient 360
Longitudinal Episode View
Search a synthetic patient or episode to inspect discharge → TCM → PCM → billing → outcomes end-to-end.
Samuel Hernandez
PT-000008 · USC-900008 · EPI-2026-0008
NBA: Verify DME delivery + patient education
Reason codes: ABNORMAL_LABS, HIGH_RISK_PROC, MULTI_CHRONIC
Outreach
2
PCM Min.
34
Paid $
$184
Age / Sex
60 · M
ZIP
90061
Language
Spanish
Payer
Humana Medicare Advantage
Procedure
Stone Removal
Surgeon
Dr. Eliot Kashani
Surgery Site
USC Pasadena Surgery Center
Surgery Date
Feb 22, 2026
Discharge
Feb 23, 2026
LOS
1d
Status
PCM Active
Consent
On file
Episode Timeline
22 eventsProgram Assignment · TCM · Eligible
2026-02-06 00:00Not accepted (Pass payer check)
Program Assignment · Post-Acute · Eligible
2026-02-06 00:00Accepted (assigned by AI Engine)
Order Set · Post-Urology Discharge Bundle · Activated
2026-02-06 00:004 orders
Intake Trigger · Surgery Schedule · USC Surgical Scheduling System
2026-02-06 18:15Routed at 2026-02-07 00:00
Program Assignment · DME · Eligible
2026-02-08 00:00Accepted (assigned by STF-010)
Surgery · Stone Removal
2026-02-22Dr. Eliot Kashani
DME Order · Synthetic Medical Supply Co · 2 item(s) · Delivered
2026-02-22 00:00E0163 Bedside commode chair · A4338 Foley catheter, 2-way, 30d supply
Discharge · LOS 1d
2026-02-23Outreach · Attempt 1 · TCM Accepted
2026-02-23 11:30Jamal Carter
Outreach · Attempt 5 · Call Back Requested
2026-02-24 08:15Sofia Diaz
DME Fulfillment · Delivered via UPS
2026-02-27Patient education pending
Exception · Referral Leakage Risk · Medium · Resolved
2026-03-01 12:00Sofia Diaz
TCM Encounter · Telehealth · CPT 99495
2026-03-04Note sent to USC
Billing · TCM Encounter · CPT 99495 · Paid
2026-03-04$184 / $184
Satisfaction · Post-TCM · 3.6/5
2026-03-07PCM Enrollment · Enrolled · consent signed
2026-03-11Satisfaction · PCM Monthly · 3.8/5
2026-03-21Care team called when they said they would.
PCM Activity · Phone Call · 5m
2026-04-06 09:20Carmen Ortiz
PCM Activity · Phone Call · 19m
2026-04-09 17:50Elena Rivera
PCM Activity · Specialist Coordination · 5m
2026-04-10 08:20Naomi Reyes
Steerage · PT → USC
2026-04-18USC Norris Cancer Hospital
PCM Activity · Phone Call · 5m
2026-04-18 17:20Carmen Ortiz
Outreach Attempts
| ID | Attempt | Datetime | Outcome | Staff | Min |
|---|---|---|---|---|---|
| OUT-0019 | #1 | 2026-02-23 11:30 | TCM Accepted | Jamal Carter | 18 |
| OUT-0111 | #5 | 2026-02-24 08:15 | Call Back Requested | Sofia Diaz | 7 |
TCM Encounters
| ID | Encounter | Type | CPT | Doc Complete | Note → USC | Staff |
|---|---|---|---|---|---|---|
| TCM-0007 | 2026-03-04 | Telehealth | 99495 | Yes | Yes | Elena Rivera |
2 satisfaction survey(s) on file — see timeline.
Actionable Chat
SyntheticNext Best Actions
Rule-based recommendations derived from the patient's current state.
Backfill PROMs RWE
LowPROMs only 46% complete
Owner: Ops Coordinator
Backfill Satisfaction RWE
LowSatisfaction only 35% complete
Owner: Ops Coordinator
Backfill PCM Monthly Activity RWE
LowPCM Monthly Activity only 38% complete
Owner: Ops Coordinator