reducing lost revenue from inpatient medical-necessity denials

If you would like to become a certified case manager then please review the program and see how it matches your career needs
Please also review AIHCP’s Case Management Certification

A data-driven approach can help hospitals limit payment denials that are based on questions of whether an admission was medically necessary. The vast majority of hospitals in the United States are all too familiar with denials of payment.

Source: insurancenewsnet.com

A big role of the certified case manager is to reduce loss revenue from insurance denials.  Proper procedure from the start of the patient’s visit can help ensure less denials.

If you are interested in becoming a certified case manager, then please review the program and see if it matches your academic and professional needs.

#certifiedcasemanager

Healthcare Needs a True Care Management System

A Care Management System is a solution that would fundamentally change how providers communicate and coordinate the care of patients.

Source: medcitynews.com

Short article on the need of a good and true health care management system for healthcare.

Healthcare management is an important key and a fluid and smooth movement of its implementation is key

If you would like to learn more about Case Management Training, then please review the program

#casemanagementtraining

Become a Certified Case Manager and Help Hospitals.

The article, “6 ways hospitals can reduce length of stays”, by Katie Sullivan states

“As hospitals and healthcare systems pinch pennies and look for ways to operate more efficiently,  a new CentralLogic report reveals six simple steps they can take to reduce length of stay and increase on-time discharge.”

American Institute Health Care Professionals’ insight:

Case Management is about quality for the patient but also reduction of price for both the institution as well as the patient.

This article looks over some simple steps to help hospitals run more financially smooth. This is very important because good case management can help hospitals and patients save funds and also improve quality assurance.

If you are someone looking to become a certified case manager, then please review our program.  If our program matches your professional and academic needs, you could become a certified case manager.

#howtobecomeacasemanager

See on www.fiercehealthcare.com

Going under the knife: Who will manage your diabetes? | MSU Extension

program in case management
Looking for a program in case management?

The article, “Going under the knife: Who will manage your diabetes?”, by Pam Daniels states

“Stay in control of your diabetes.”

American Institute Health Care Professionals’ insight:

This is a good article for Diabetics who are facing surgery and the worries of not only recovering but treatment of the diabetes.  As we all know diabetes is a serious illness and without proper treatment, especially during surgery, it can become a serious situation. This is where good preparation comes into hand and also good case management. 

Your medical team and certified case manager should be able to help you in this area of concern as they overlook your overall recovery.  This is critical they have a case history of your diabetes and are all on the same page.  A certified case manager can be the leader in this case and help coordinate all the medical professionals in your recovery with special emphasis on your diabetes and its particular treatment.

If you are interested in learning how to become a certified case manager, then please review the program in Case Management.

Our program in Case Management consists of five core courses.  After completion of those courses, qualified professionals can become eligible to become certified in case management.

If one wishes to recertify in our program in Case Management after three years, they have to accumulate over five hundred hours of case management relevant service and sixty hours of case management continuing education.

In the meantime, please review our program in Case Management and the various articles.  If you have any questions please let us know and we will be more than glad to help you.

#becomingacasemanager

 

See on msue.anr.msu.edu

Health Care Case Managers: Using Case Management to Help a Child With Autism

The article, “Using Case Management to Help a Child With Autism”, by Gregory Ruel states

“Portland, Maine — Parents of children with autism are rightfully worried about the best path for their child.”

American Institute Health Care Professionals’ insight:

Health Care Case Management is important in health care.  It is important in dealing with everything from a medical perspectiveOn many occasions, a case manager can be the difference in a family finding treatment or being billed correctly.

Health Care Case Managers can also help children with autism.  Health Care Case managers can help families find cost friendly services to assist families.  Many families are not aware of many of the state aids that are available that good health care case managers can find for them.

Please review the article and in the meantime, if you have any interest in case management, or wish to become certified in case management, then please review the program.  To become certified as a health care case managers, qualified professionals need to take the five core courses in Case management.  After completion of the courses, the professional is eligible for certification.  Certification in case management lasts four years and can be renewed.

In the meantime, health care case managers should enjoy the blog and read the articles.  If you are not a case manager, then still stay and catch up on some important issues in health care, or feel free to browse our site or other blogs that we have.

#casemanagementprogram

 

See on www.webwire.com

Learning More About Case Management: Tips on Getting Life Insurance following Heart Surgery

Tips on Getting Life Insurance following Heart Surgery

Are you interested in obtaining life insurance after having had heart surgery? It may be difficult but not impossible, and the tips listed below should help.  Many Case Managers would suggest these things

1. Wait a year

Your best bet in getting life insurance after you have had heart surgery is to wait at least one year before trying to obtain a policy. This type of policy will be simplified issue and will be available in almost all states. If you acquire guaranteed issued insurance, you will not need to wait a year. The policy will be issued immediately but will take up to two full years at a minimum before it will pay out 100%.

2. Medically underwritten policies

• If you are interested in obtaining a policy that is medically underwritten, you will need to meet certain criteria. It will be necessary for your heart surgery to be a one-time incident. It will also be necessary that you did not have a heart attack or suffered only a mild one. You will need to follow a lifestyle that is healthy for your heart, and you will also be required to have gone through enough time without incident that you are able to go off of any blood thinners. Even if all of these criteria have not been met, you may still be able to acquire a medically underwritten policy that contains what is known as a “flat extra,” which is an additional charge applied to the policy for a specified period of time.

• You will also be required to produce medical proof to your prospective insurer that you are in good health at the present time. This may include an EKG printout, stress test results, or a chest x-ray.

3. Check out a number of companies

You will want to acquire a number of quotes from a variety of life insurance companies to ascertain which agency can give you the best policy at the best price. You can do this on your own or you can go through the services of a reputable agent who will have firsthand knowledge regarding the best life insurance companies for individuals in your particular situation.

4. Lose weight, if necessary

If you tend to have problems with being overweight, it will help your health and your efforts to get a life insurance policy when you shed unnecessary pounds. Insurers consider your current lifestyle when you apply for a policy, and they will not want to see that you are carrying extra weight that could place an unnecessary burden on your heart.

5. Do not smoke

If you are presently smoking, quit the habit and stay away from all tobacco products. There is not an insurer alive who will want to provide a life insurance policy to an applicant who still smokes despite the fact that he or she has had heart surgery.

By following the tips that are listed above, you can greatly increase your chances of obtaining a good life insurance policy even after you have had heart surgery.

Author Bio: Claire Atkinson writes for  Kanetix.ca, a comparison website that has more information on obtaining life insurance

If you would like to learn more about insurance or if you are a qualified nurse or health care professional interested in learning more about case management, then please review the program at AIHCP

Which Nursing Certification Would Best Suit You?

Find Out What Nursing Certification Finds Your Career Needs.

Every nurse knows that nursing education does not stop when they receive their RN.   You must increase your knowledge and constantly learn new technologies.   There is also the question of do you want to specialize your nursing career with a nursing certification in a specialty field?

Which nursing certification would you choose?

When looking for a nursing certification, you need to look for the best possible field to fit your career goals.    For example if you want to go into case management then you would want to look for online nurse case manager training.   Likewise for legal nurse consulting, nurse patient educator, etc.    Your next step would be choose the nursing training.

When choosing your courses do you want to physical attend classes or would online nurse training better fit your needs?   Both have positives and negatives to them.   In the end you need to decide which one would best suit your situation.

When you decide to earn a nursing certification, you will be taking positive steps to better yourself and your career.   Online nurse training is great for nurses who still need to work full time.   It gives you the flexibility your job can demand!    If you are in the market for a high quality online nursing certification then you might want to visit the American Institute of Health Care Professionals.   They offer online nursing courses in several different specialties.

Become a certified case manager

Become a certified case manager
Become a certified case manager and enter into the field of health care reform

The article, “What Healthcare Reform Means for Providers”, by BHM Marketing states

“Healthcare Reform has brought about many changes, especially for providers. Failure to comply can result in substantial penalties. Are you ready? Are you complying 100%?”

American Institute Health Care Professionals’ insight:

Certified case managers should have a strong understanding of how the new health care law will effect providers.

Dealing with providers and patients and how payments are given under health care is an everyday affair for health care managers.  Hence, this article will be of some use for those who have not investigated many of the new issues.  This article  looks at regulatory and cost issues that health care providers will have to deal with in the new future.

If you are interested in case management or would like to learn how to become a certified case manager, then please review the program.

See on www.bhmpc.com

Certified Case Managers and the Healthcare Insurance Exchanges

certified case managers
What do certified case managers need to know about the healthcare exchanges?

The article, “5 Things to Know About the Healthcare Insurance Exchanges”, by Emily Deruy states

“A new survey suggests many remain confused about the marketplace.”

American Institute Health Care Professionals’ insight:

It is important to understand the nature of the healthcare insurance exchange because it affects everyone and is a law.  Case managers can guide you as well but this article gives some important information you may need down the road.   Certified case managers need to be prepared to answer questions involving the insurance exchange.

#casemanagementprogram

See on abcnews.go.com

Health Care Case Management and Social Work

Role of the Social Worker in Health Care Case Management

Social Work Health Care Case Management is a way of providing the needs and services of a client as well as to his or her family. The person who does this is called a social worker. A social worker has got various roles that include advocates, evaluates, monitors, coordinates, and arranges where appropriate. In order for the social worker to execute duties efficiently, he or she should undergo training and education. The social worker should meet the following conditions so as to be a qualified social worker.
� Should be a graduate from a Masters program recognized by Council on the Social Work Education.
� Should maintain the current professional national social work certification or the state social work certification.
� Should complete the 2 years of master’s degree in order to gain work experience associated with the social needs of the population he or she is serving.
� Should practice according to the federal regulations, laws, and statutes as well as with applicable state.
� Should adhere to the NASW Social Work Code of Ethics.   and Should have education and training, as well as Certification in Health Care Case Management
ShAfter the social worker has completed the training, her/she will generally perform the following as a Certified Case Manager the following duties.
Broker
The worker takes part in the process of making the referrals in order to link a person or family to the required resources. They not only provide information but they also follow up you in order to make sure that you have achieved the required resources. This requires one to know eligibility requirements, resources, location and the fees of the services.

Advocate
This is also another role of the social worker in health care case management. They fight for the rights of other people and work in order to obtain the required resources by convincing the others about the legitimate rights and needs for the members of the society. They are particularly concerned with those who are vulnerable or are not able to speak up for themselves. Advocacy may occur in the county, local, national or even state level. Some of the social workers do participate in international human rights as well as advocacy for those who are in need.

Case Manager
They are still involved in assisting and locating services to their clients so that clients can access the services.  Health Care Case management is very important for the complex situations as well as to those who are elderly or homeless, who have mental or chronic physical health issues, who are disabled, the victims of violence or domestic crimes and the vulnerable children.

Educator
This is still another role of the social worker in health care case management. Social workers are mostly involved in educating other people about the resources as well as how to develop certain skills like budgeting, prevention of violence, the meaning of the medical diagnosis, effective communication, caring and disciplining children.

Facilitator
In this duty, social workers participate in gathering together the groups of people due to a variety of reasons including policy change, political organization, self advocacy, and community development. Social workers take part as task group leaders and group therapists.

Organizer
Social workers are still involved in many various levels of the community organization as well as actions such as policy specialists, researching, union organization and economic development.

Manager
Since social workers are experts in a wide range of applications, they are therefore suited to work as supervisors and managers in
nearly every setting. They are capable of influencing policy change or development and advocate for the underprivileged people.

Clinical services
They provide services that include information and referral, representative payee services, housing maintenance and location, public benefits assistance, ongoing therapy, casework to secure shelter, food, clothing and any other emergency assistance, care coordination and case management and finally crisis intervention.

Clinical and support groups
Clinical staff and social workers facilitate a variety of groups for promoting overall psychological and physical wellness. Group topics include stress reduction, art, writing, acupuncture, life skills, women’s and men’s peer support and many others.

Case conferences
Social workers participate and organize routine clinical case conferences that involve nurses, doctors, counselors and other providers who are involved in the client area in order to find better ways of assisting people.

Generally, social workers have got very many roles in order to help the community and therefore they are very important people in our communities and the above is just a sample of their roles.  If you are interested in learning more about health care case management, then please review the program