Patient status

A case manager works to help a hospitalized patient who is out of Medicare Part A benefits successfully transition to a rehabilitation facility.

A final rule issued by CMS in February includes several changes to Medicare Advantage (MA) regulations aimed at ensuring health equity, quality, and safety.

Review three recent clinical and regulatory developments that are important for case managers to know about.

Tiffany Ferguson, LMSW, CMAC, ACM, CEO of Phoenix Medical Management, gives advice on two common ethical scenarios in case management.

Amanda, a nurse case manager, is working the holiday weekend and covering a different medical assignment than usual.

Kelly, a cardiac case manager, must coordinate a patient's discharge and difficult transfer plan.

As case managers review the medical record and interview the patient, family, and medical team, they must dig deep and ask hard questions to ensure any unforeseen financial or medical needs are met.

Amanda, a surgical case manager, learns that her patient, Evan, lives in a region so remote that there are no home care services available.

Contract negotiations can make or break a hospital, because in addition to setting the price list for services provided to the insurer’s members, the negotiations also affect the resources that the provider expends to comply with the contract terms. Use this sample language as a template for your organization.

Debra, a case manager, helps a patient who has undergone plastic surgery six times in the past six years.