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Case Management
Pre-Health Professional Development (HLTH 3300)
The University of Texas at Dallas
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Case Management
● Process is done by case managers who do this, usually healthcare professionals who decided to go to this side ● You have to have a lot of knowledge to do this job, so now there is a requirement of certification; CCM = certified case manager ○ Must have worked 3-5 yrs to know enough to take the exam ○ Case Management Society of America ● Takes place in any outcare patient place; not just hospitals, but doesn’t occur for flu shots (less extensive, not refills). Occurs when a patient has surgery, acute rehab → out patient., going to other facilities ● Managed care company (Aetna, cigna, or medicare) helps when patients has contact with the hospital ● The case manager follows the patient and their care; he/she finds out by calling the people that the patient’s been in contact with ● Case manager approves things like physical therapy ● This is all going to come back to your salary, so give them thorough information and cooperate with case managers when asked to ● Document well so you don’t get frequent calls from case managers ● There’s a difference between paying for care from3 to 2 weeks ● There are places where patients have to stay for 4 weeks (case managers flag them) ● Case manager also calls up the patients to let them know of their options, so they don’t have to do the most expensive option ● Patients go through continuum Life Care Planning ● For seriously impaired/injured patients (ex. abled person suddenly becomes a paraplegic) ○ Because they’re having multiple surgeries, therapies, treatment; in a variety of places for a long time and where can this person and how will we pay? ● These people have more training than the case manager, what kind of places are there, legal issues, manage extensive things • getting care for the rest of their life ● They work for life care planning companies of large law firms
● PTS and OTS can do this as well ● Different facilities will have different limitations so life care planners have to do extensive research ○ An 85 y who had a stroke would not have this service
Case Management
Course: Pre-Health Professional Development (HLTH 3300)
University: The University of Texas at Dallas
