Q&A: Case management collaboration with finance and the revenue cycle

Q. How can case managers and social workers align themselves with the revenue cycle?

A. Positioning case managers and social workers in healthcare access points will align a case management program with the healthcare revenue cycle flow. Access points include the following:

• Preadmission and scheduling
• Bed management
• Inpatient hospital-based case coordination and utilization management (including denials and appeals, clinical and psychosocial discharge planning)
• Post-discharge follow-up models
• Community primary care and clinic settings

These service points not only facilitate financial eligibility for patients but also continuously redress accurate demographic and payer status that positively impacts revenue cycle.

For more information, see Social Work: Strength-Based Practice in Hospital Case Management.

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