Download or read book The Hospital Case Management Orientation Manual written by Peggy Rossi, Bsn, Mpa, CCM and published by Hcpro, a Division of Simplify Compliance. This book was released on 2014-06-12 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Case Management Orientation Manual Guide is a comprehensive resource that supplements of initial training for new case managers. This book explains what to document, where to document it to ensure appropriate level of care and reimbursement, and how to avoid unnecessary denials. This book's focus is utilization management, discharge planning, and relevant CMS regulations. It can help new case managers learn how to perform their jobs effectively on their own time. It can also serve as a wide-ranging resource for more experienced case managers, particularly those whose training was less than adequate.
Download or read book Core Skills for Hospital Case Managers written by Tony Cesta and published by HC Pro, Inc.. This book was released on 2009-06 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: Core Skills for Hospital Case Managers: A Training Toolkit for Effective Outcomes Toni Cesta, PhD, RN, FAAN; Beverly Cunningham, MS, RN As of June 20, 2014, contact hours for nurses are no longer available with this product. Finally--an affordable, effective, and consistent training program for your hospital case managers. This one-of-a-kind guide to fundamental case management responsibilities is a necessary reference tool for every hospital case management department. This resource is designed to give case management directors and hospital leaders the tools they need to build and strengthen the basic and advanced skills their case management staff needs to succeed. Core Skills for Hospital Case Managers is an orientation and training manual for nurses transitioning into case management, an easy-to-read reference guide for new case managers, and a source of inspiration, tools, and resources for seasoned professionals. With a flexible format, this book and CD-ROM offer practical information and customizable tools to develop and maintain a wide variety of care management skills. Table of contents Chapter 1: Hospital Case Management 101 Chapter 2: Case Manager Role Chapter 3: Roles, Functions, and Caseloads Chapter 4: The Case Management Process Chapter 5: The Case Manager's Role in Transitional and Discharge Planning Chapter 6: Utilization Management Chapter 7: Managing Long Length of Stay Patients Chapter 8: Denials: Prevention and Appeals Strategies Chapter 9: Reimbursement Chapter 10: The Role of the Case Manager in Patient Flow Chapter 11: Measuring Success: Strategic Outcome Measures Chapter 12: Dealing with the Uninsured and Underinsured Chapter 13: Working with Multidisciplinary Teams Chapter 14: Crucial Communication and Conflict Resolution Learning objectives: Discuss the evolution of hospital case management Explain the different models of hospital case management Determine the various goals of hospital case management Examine the various roles of case management Discuss the variety of functions performed by case managers Discuss the scope of the case manager position Examine staffing ratios in various models List the steps in the case management process Determine the role of case managers in documentation Examine case managers' role in discharge planning List the factors that influence the discharge planning process Determine strategies for improving discharge planning Discuss how hospital reimbursement affects utilization management (UM) List the stages of UM coordination Determine the affect of outside influences on UM Evaluate different payers' regulations regarding UM Examine case management's role in length of stay (LOS) Evaluate strategies for managing patients with long LOS Identify data used to track and trend LOS Evaluate the reasons behind denials Discuss case management's role in preventing denials Examine case management's roles in reversing denials Examine case management's role in reimbursement Determine strategies for effective case management related to reimbursement Evaluate case management's role in patient flow Discuss demand and capacity management Identify strategies for managing patient flow Identify measurable case management outcomes Explain how case managers can track quality outcome metrics Discuss other metrics case management departments can track and trend Examine ways to create a case management report card Discuss the unfunded or underfunded patient populations Describe the role of the ED case manager with unfunded or underfunded patient populations Evaluate strategies for dealing with unfunded or underfunded patient populations Examine strategies for successfully working with multidisciplinary teams Describe sources of conflict with which case managers frequently come in contact Discuss strategies for reducing conflict Intended audience Staff nurses, charge nurses, staff educators, staff development specialists, directors of education, nurse managers, and nurse leaders
Download or read book Case Management written by Arthur J. Frankel and published by Oxford University Press, USA. This book was released on 2019 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the course of twenty years and across three editions, this text has approached case management as both an art and a science by providing students and practitioners with the basics of case management theory, skills, and applications. This fourth edition, which focuses on both the social work and nursing professions, offers trainers, instructors, and students detailed information about how case management is delivered, major issues encountered in practice, how services are affected by different populations, and the unique skills that are required by case managers in order to be effective. Chapter exercises and numerous case examples help readers practice some of the skills associated with the content offered.Case Management is unique in that it brings together the major professions that conduct case management in the United States. It is focused on skill learning more than on theory, and discusses not only the importance of case management in the current social work and medical milieu, but also the challenges that case managers face in helping clients. In addition, the text offers a model for integrated case management between professions and in numerous settings, including nursing centers, community mental health facilities, and criminal justice centers.
Download or read book CMSA Core Curriculum for Case Management written by Hussein M. Tahan and published by Lippincott Williams & Wilkins. This book was released on 2016-07-05 with total page 862 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fully updated CMSA Core Curriculum for Case Management, 3rd edition, is the definitive roadmap to an informed, effective, collaborative case management practice. This comprehensive, expertly-written guide provides those directly or indirectly involved in case management with information about best practices, descriptions of key terms, essential skills, and tools that fulfill the current Case Management Society of America’s (CMSA) standards and requirements. Addressing the full spectrum of healthcare professional roles and environments, this is both a crucial certification study guide and vital clinical resource for the case management professionals in all specialty areas, from students to veteran case managers. This unique resource provides the core knowledge needed for safe, cost-effective case management with the following features ... NEW text boxes highlighting key information and vital practices in each chapter NEW and updated Standards of Practice implications in each chapter NEW and updated content on transitions of care, community-based care, care coordination, Value-Based Purchasing, ethics and social media, the impacts of health care reform, and digital technology NEW and updated content on accreditation in case management NEW chapter that lists key additional resources, by topic Official publication of the Case Management Society of America, connecting CMSA core curriculum to current CMSA Standards of Practice Easy-to-grasp, detailed topical outline format for quick scan of topics Complete, updated core knowledge required of case managers, with expert descriptions and direction on areas including: Case management roles, functions, tools, and processes Plans, clinical pathways, and use of technology Transitional planning Utilization management and resource management Leadership skills and concepts Quality and outcomes management; legal and ethical issues Education, training, and certification Health care insurance, benefits, and reimbursement systems Practice settings and throughput Interdisciplinary teams’ needs in: hospitals, community clinics, private practice, acute care, home care, long-term care and rehab settings, palliative care, and hospice settings Up-to-date guidance on case management specialty practices, including: nursing, life care planning, workers’ compensation, disability management, care of the elderly, behavioral health, transitions of care, subacute and long-term care, utilization review/management, primary care and medical/health home, and more Essential content for academic reference, training, certification study, case management models design, performance or program evaluation
Download or read book Social Work Case Management written by Betsy Vourlekis and published by Routledge. This book was released on 2017-07-05 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: This new practice text provides a series of readings focusing on case management in a number of fields and in a variety of settings with different client populations. Each chapter examines a major component of case management practice by presenting information about an innovative program from a different location around the country. In conjunction, these readings provide a road map to social work case management.In addition to offering up-to-date practice approaches and examining the functions and skills of case management in depth, the authors provide the policy information needed for putting this traditional form of social work practice into today's service delivery context.
Download or read book A Practical Guide to Acute Care Case Management written by Colleen M. Morley DNP CCM CMAC CMCN ACM- and published by . This book was released on 2021-12-15 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Case Management written by Suzanne K. Powell and published by Lippincott Williams & Wilkins. This book was released on 2018-02-26 with total page 914 pages. Available in PDF, EPUB and Kindle. Book excerpt: Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition. Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home. Build a strong case management career foundation, with expert, evidence-based direction: NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development Offers in-depth, evidence-based guidance on: The case manager’s roles, functions, and tasks Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care The role of the nurse case manager versus social worker role Strategies that ensure effectiveness of case management models Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications Management of resources and reimbursement concepts Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management
Download or read book Case Management Models Second Edition written by Karen Zander and published by Hcpro, a Division of Simplify Compliance. This book was released on 2017-06-28 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Explains the differences between case management and social work and the ways in which case management functions have evolved over time. Case management is continuously evolving to meet the needs of patients and manage the quality, financial, and legal risks health care systems and accountable care organizations (ACO) face.
Download or read book Nursing Staff in Hospitals and Nursing Homes written by Institute of Medicine and published by National Academies Press. This book was released on 1996-03-27 with total page 558 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
Download or read book Family Oriented Primary Care written by Susan H. McDaniel and published by Springer Science & Business Media. This book was released on 2013-03-09 with total page 398 pages. Available in PDF, EPUB and Kindle. Book excerpt: A family orientation in health care can provide a wider understanding of illness and a broader range of solutions than the classic biomedical model. This volume thus offers practical guidance for the physician who would like to take greater advantage of this resource. The result is a readable guide, structured around step-by-step protocols that are vividly illustrated with case studies drawn from the authors extensive experience at the University of Rochester School of Medicine.
Download or read book Discharge Planning Handbook for Healthcare written by Ali Birjandi and published by CRC Press. This book was released on 2017-11-15 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hidden opportunities to improve profits in the healthcare industry abound in the area of discharge planning. The Discharge Planning Handbook for Healthcare: Top Ten Secrets to Unlocking a New Revenue Pipeline provides innovative new solutions that will show hospital administrators how to turn one of the most antiquated aspects of healthcare into on
Download or read book Health and Human Services Issues written by United States. General Accounting Office and published by . This book was released on 1993 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: Discussing major policy, management, and program issues facing Congress and the Clinton administration in the area of health and human services, this pamphlet provides recommendations for the Department of Health and Human Services (HHS) regarding the social security system, the welfare system, preventing child abuse, and safeguarding the nation's food supply. Following an overview of important issues facing the nation, the second section suggests steps to bolster public confidence in the social security system, including building the system's trust fund by increasing contribution levels and modernizing computer systems. The next section provides recommendations for continuing the welfare reform movement and the implementation of the Family Support Act, such as developing automated data systems to effectively manage caseloads, setting goal-oriented program performance standards, and identifying and sharing effective initiatives between states. The fourth section suggests that HHS provide states with greater flexibility in using government funds to prevent child abuse through early intervention and that a national foster care system be developed to provide outcome-oriented data on child welfare services. The final section proposes that an agency-wide system for tracking regulation development be implemented in the Food and Drug Administration to improve agency effectiveness and better allocate existing resources. Includes references for 22 related GAO products. (BCY).
Download or read book Emergency Department Case Management Second Edition written by Kathleen Walsh and published by . This book was released on 2014-11-14 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: From defining goals, clarifying roles, and understanding the necessary knowledge and skills required, Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition will ensure that ED case management staff have a solid and sustainable foundation in place. After exploring models and reviewing emergency department infrastructure, this compendium will help readers outline key partnerships, present multiple options for case finding, tackle observation status accurately, address quality and evaluation issues, and identify ways ED RN case managers and social workers coordinate care for complex cases, such as pediatric, psychiatric, homeless, and uninsured populations. In addition to many new tools, this book is also packed with more than 20 detailed spotlights and case studies discussing ED case management strategies, best practices, and experiences of ED professionals from across the country. The new edition includes: The presence of case management RNs and Social Workers in emergency departments (ED) has become a standard since the first edition of this text was published in 2007. Ever-expanding and changing regulations for EDs and hospitals have emerged, while best practices have evolved to address these challenges. This new edition discusses these changes and provides updated guidance on running a compliant, effective, and efficient case management team in the ED. It also provides insight on adapting the role of case management based on unique ED patient populations and helps ED case managers stay ahead of the curve by examining what lies ahead in their profession.
Download or read book The Integrated Case Management Manual written by Roger G. Kathol, MD and published by Springer Publishing Company. This book was released on 2010-06-03 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: Designated a Doody's Core Title! An ideal reference guide for case managers who work with complex, multimorbid patients, The Integrated Case Management Manual helps readers enhance their ability to work with these patients, learn how to apply new evidence-based assessments, and advocate for improved quality and safe care for all patients. This text encourages case managers to assess patients with both medical and mental health barriers to improvement in order to coordinate appropriate integrated health interventions and treatment planning. Built upon the goals and values of the Case Management Society of America (CMSA), this manual guides case managers through the process of developing new and important cross-disciplinary skills. These skills will allow them to alter the health trajectory of some of the neediest patients in the health care system. Key Features: Tools and resources for deploying an Integrated Health Model (physical and mental health treatment) to the medically complex patient Complexity assessment grids: a color-coded tool for tracking patient progress and outcomes throughout the trajectory of the illness Methods for building collaborative partnerships in emerging models of care delivery within multidisciplinary health care teams Strategies for using an integrated case management approach to improve efficiency, effectiveness, accountability, and positive outcomes in clinical settings Guidance on connecting multi-disciplinary teams to assist with health issues in the biological, psychological, and social domains to overcome treatment resistance, reduce complications, and reduce cost of care
Download or read book The Case Manager s Training Manual written by David W. Plocher and published by Jones & Bartlett Learning. This book was released on 2001 with total page 332 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stem Cell and Bone Marrow Transplantation
Download or read book The Hospital Guide to Contemporary Utilization Review written by Stefani Daniels and published by . This book was released on 2015-04-16 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives
Download or read book Case Management and Rehabilitation Counseling written by Richard Roessler and published by . This book was released on 1998 with total page 364 pages. Available in PDF, EPUB and Kindle. Book excerpt:
