Case Managers need to understand future implications of Obamacare on alternative medications.
WMBFnews, a NBC affiliate writes that other forms of medicine once considered alternative could be covered under Obamacare. This topic is covered in the article, “Obamacare to Cover Acupuncture, Alternative Medicine”
“Under the Patient Protection and Affordable Care Act (ACA), otherwise known as “Obamacare,” what is now called alternative medicine may become as accessible and as widely accepted as conventional medicine.”
Good Case Management skills can prove to be good records for truth in malpractice whether the patient or the doctor is in the wrong. The article below talks about the rise of malpractice in the United States.
To learn more about case management certifications, please click here
Nursing case management is becoming more important in overall health care delivery. A nurse case manager must wear many hats and juggle many tasks at once in order to be successful at his or her job. Perhaps one of the most important aspects of being a case manager, however, is acting as a patient advocate. This is such an ingrained part of being a case manager that many nurses act as an advocate without even realizing it by doing things like noticing a prescription medication error. There are many other aspects to the role of the nurse case manager as patient advocate, however. Below we’ll highlight some of them, with an emphasis on how nurses advocate for their patients to receive care and social support.
What is advocating?
There are many different definitions of patient advocating. They may depend on a nurse’s personal philosophy or the setting in which he or she works. In general, advocating means standing up for your patient and your patient’s rights. To advocate properly, a nurse case manager must set his or her personal preferences aside and realize that excellent health care is focused on the patient’s needs instead of the needs of her caregivers.
Advocating may involve speaking up in order to get the best care for your patient, but it also may simply involve being an understanding and accepting caregiver. For example, many patients have personal or religious qualms about giving or receiving blood. Being a patient advocate involves not judging these patients or condemning them for not making the medically “appropriate” choice. Advocacy involves supporting their choice while at the same time educating them about their options.
Advocacy isn’t always comfortable
There are times when advocating can put a nurse at odds with his or her employers. The number of nurses, however, who ignore these difficulties in order to provide their patients with optimum care is staggering. For example, at a hospital in Texas, two nurses came forward to identify a physician who they felt was negligent with patients. They believed this physician put some patients at risk and they told the administrator at their hospital. When the administrator failed to act, they went to the Texas Medical Board with their complaints. They were fired and then charged for misusing official information. Eventually the charges were dropped against one of the nurses and the other was quickly acquitted. Their defenses were paid for by donations raised by the Texas Nurses Association.
Although these two nurses went through an extremely difficult ordeal, they did it because of their drive to act as a patient advocate. This is perhaps the ideal example of working for your patient’s rights as these two ignored potential threats to their own careers in order to get the best care for their patients.
The benefits of advocacy
A nurse may benefit from advocacy as it makes him or her feel better about the job they are doing. Most who enter healthcare professions do so because they are concerned about their fellow human beings. Advocacy truly allows for the expression of that motivation.
The true benefits of the nurse case manager as patient advocate appear as benefits to the patient, however. Nurses are the main system of support for patients, and are responsible for easing their transition through the different levels of treatment in a hospital (such as emergency, surgery, etc.). They are also the ones who provide patients with emotional support and often do the same for the families of those patients. Without the support offered by nurses, many patients would have a frightening, confusing, and overwhelming medical experience.
Many healthcare facilities are beginning to recognize the importance of the patient advocacy. They have begun instituting ways to protect nurse’s from repercussions if they are simply advocating for their patients. There have even been some nurses who have taken their skill for advocating and turned it into a full-time career. Private and public groups, whose primary duty is advocacy, have sprouted up in recent years. These groups help patients navigate through the daunting decisions inherent in a healthcare process.
Advocacy is an often overlooked, but critically important part of nursing. Without it many patients would be lost to navigate a complex healthcare system on their own. Patient advocacy is one of the more selfless acts we see in healthcare, and it’s part of what makes the nursing profession special. To learn more about nursing case management, click here.
Sometimes, the health insurance market can feel like a minefield. It doesn’t have to feel that way, though. There is plenty of advice available that can help you get the best deals and the best treatment out of the money and time you put into dealing with health insurance companies. Read on for some handy tips in care management
To save money on your health insurance plan, do not be fooled by plans with offers that are too good to be true. For instance, some plans may not require any fees for particular everyday preventative care, but do not have the benefits that many other health insurance plans offer.
If you have an adult child who does not have their own health insurance, you can keep them on your policy until they are 26 years old. This means that they do not have to forgo health insurance or pay for their own policy while trying to get established in a career.
You need to know what the terms are in your coverage when getting ready to switch health insurance policies. This is especially true of the rates. The rate refers to the amount a provider is paid for your policy. You need to get the most cost-effective rate you can. Make sure to weigh the cost of the rate with your income, deductible, annual medical costs, and coverage. Sometimes a case manager can help with this.
Get to know the three major types of health insurance policies: the HMO, the POS, and the PPO. Research these three types to find out how their coverage, policy rates and programs differ. Use this information to figure out which one would be best for you and your family.
If you fear being laid off from your job, you may consider enrolling in a plan with a low premium. Since the government program that offset much of the cost of COBRA has ended, continuing your insurance coverage in the event of a layoff would come entirely from your own pocket, which could prove very difficult if your premium is high.
If you’re looking for an insurance broker for health insurance, ask your friends and relatives for a referral. There are many brokers with a license out there, but not all of them are going to do the best job for you. Online reviews can easily be faked, so they’re not very reliable, either.
One important feature of any insurance plan is prescription drug coverage. Be sure to scrutinize all the details of your prescription drug plan so that you are familiar with how your healthcare insurer handles prescriptions. It’s especially important to understand how they cover different classes of drugs, and whether they offer generics for the prescriptions you normally take.
Understand the differences between a PPO policy and a HMO policy if you want to receive the best possible level of care with your health insurance. You not only have to think about what’s best for you, but also what’s best for your children – if they should happen to fall ill or suffer an accident.
Depending on the demographic makeup of your office, employer based insurance may not be the best for you. Insurance plans are built upon spreading out the risk. If you are the youngest person in an office, working with a group of people nearing retirement, you will pay more for your insurance to cover for them. Always check with outside insurance before choosing to go with your employers.
A vital health insurance tip is to never abandon your claim just because it has been initially denied. Filing an appeal is always an option, and it is important to note that the denial could simply have been the result of a data error in the insurer’s computer system. By appealing unexpected denials, you have the power to receive every bit of coverage your policy is meant to provide. Again a care manager can aid you in overcoming denials.
No matter what, make sure you have some sort of health insurance. The bills that pile up from an emergency when you don’t have insurance, can cause you to go into bankruptcy or spend the rest of your life paying for one accident or health issue. The cost of uninsured medical bills is too high to risk. Get coverage no matter what.
If you are committed to finding the best deals, this is just the beginning of your health insurance education. Hopefully, a few of these ideas will be helpful to you. There are more where they came from; keep learning to zero in on the very best health insurance you can find.
You can seek the advice of a care manager or learn about care management by reviewing our program. To review and become a certified care manager, click here.
A nursing case management professional hard at work!
In the field of nursing case management is a skill set that continues to become more and more important. With the current state of health care, the ancillary issues – those that do not relate directly to treatment – have been multiplying, and sorting through them without professional assistance has become more of a challenge. Learning about and becoming certified in the field of case management allows nurses to offer that professional assistance to their patients. A nurse who is also a competent case manager can help resolve treatment conflicts, coordinate treatment provided by different specialists, sort out the serious financial ramifications of health care, and, generally speaking, minimize the bureaucratic hassles a patient experiences. The value of this skill to patients makes it a valuable skill to health care providers, too. A nurse that takes the time to cultivate case management skills will find that his or her value to employers will rise significantly.
Social services case managers are normally men and women that have sociology backgrounds. Their job is to assess the needs of their clients along with their families. Once their needs have been assessed, they are responsible for arranging coordinating and monitoring the available resources to meet the needs that have been identified. To become a social services case manager, it will require a certain amount of work experience, social work education as well as professional credentials. Each individual must also be able to interact well with others including culturally diverse clients. In order to help their clients with what they need, they must also communicate with different types of community resources and a wide range of social service agencies. For those who are interested in pursuing a career in social work case management, the first step is to earn a four year degree in social work or a related area
Many times caring for a loved one in a home environment can often become overwhelming. The instructions that the person receives from the physician and other medical professionals are not always an easy transition for those who are on the outside of the medical field. For example, the patient’s physician may give the caregiver instructions on medications in the morning hours, they may also receive wound-care instructions from their nurse in the afternoon hours, and they can talk to a social worker about the patient housing needs before the end of that same day. This is one of the main reasons why case manager is assigned to cases so that they can assist the family with navigating through these different options. Case management servicescan also help the family with getting the proper professional health care in the home. There job is to help by advocating on behalf of the patient so that they can get have the best outcome for their medical care. If you are interested in the program, please review and see if it fits your academic and professional needs.
How Can Case Management Help Understand Health Insurance?
How can case management explain health insurance do you?
With so many types of health insurance out there, finding one for you and your family might be tough. Ask a case management nurse can be very helpful. In the case of a medical emergency, that little card can literally be life-saving. This article provides case manager health insurance tips that can benefit you.
Catastrophic health insurance coverage, as explained by case management professionals, is an option for individuals that cannot afford a standard health insurance policy. Catastrophic coverage will protect you in case you experience a severe, life-threatening illness or an unexpected accident of injury. This kind of coverage is also good to add to an overall health care plan as extra coverage when there are extreme circumstances.
Ask your doctor to increase the dose of your prescription to save a few bucks. Often, buying pills in larger doses does not significantly increase the cost so you may be able to save money by cutting the pills in half. This can actually pay for your pill splitter.
Nursing case manager sorting files.
Watch your bills, suggests nursing case managers. Even if you have a good health plan, you might get charged for items that will surprise you, such as prescription medication. Some doctors don’t think of generic (and cheaper) versions of medications, and just prescribe the brand name medicine. Don’t hesitate to compare prices as well. The price of the same medication can vary widely at different pharmacies.
The premiums on health insurance are not rigid; consumers can decide what will and will not be part of their benefit plans. For example, you may exclude things like prescription coverage, vision and dental coverage or co-payments on doctor visits. Keep in mind that the more benefits that you chose to have the higher your premium will be and the less benefits the lower your premium.
Health insurance policies often times include different incentives to help you stay healthy. Many health insurance companies now offer discounts on gym memberships, annual medical checkups, quit smoking classes, weigh loss plans, healthy eating classes and annual flu shots. In addition, your premiums may be lowered if you take advantage of these opportunities to save.
If you are qualified, you can get a medical care card at discount, which could give you lower cost insurance coverage from your insurer. This card allows you to go to a doctor in their network that offers reduced cost healthcare for those with low incomes. In some cases, you can even obtain health spending accounts that give you additional ways to take care of your costs.
In the end, it is cheaper if you have a group plan, that is why you have cheaper premiums if you work for someone. The best way to get around this is to become a member or a trade organization that has insurance available to its members.
Raise your deductible to find more affordable premiums for health insurance. If you will increase your deductible, you can significantly lower your health insurance premium. Keep in mind that although your premium will be lower, you must spend more each year before your insurance will pay part of the costs.
If you require health insurance and have are a recent college graduate, there are some things for you to think about. If you’ve got a job, use the employee-based insurance it provides. You can also be listed under your parents’ policy until you turn twenty-six, or look into personal plans.
A case manager can help you understand your health care.
No matter what, you will save money by buying generics over brand name drugs. Generics are available in most cases and contain the exact same ingredients as a brand name. Check with a nurse case manager to find out the list of generic drugs you can take.
Check with your health insurance carrier to know what prescriptions are covered under your policy. This list will be different every year or so, so make sure you check it when you enroll again to avoid a surprise at the pharmacy when filling your medication.
The first thing to do is find a suitable company when you apply for health insurance. Another organization is a Preferred Provider,(PPO) which has their own network to pick from; they will allow you choose a doctor from another network, although there is a fee involved. A POP or Point-of-Service plan lets you pick a PCP, but they’re allowed to refer you outside that network.
If issues with your vision have arisen, or if there are hereditary factors that could cause problems in the future, consider an insurance policy that covers vision. The insurance will likely cover some of the cost of doctor visits as well as a portion of costs related to contact lenses and glasses. Insurance for vision is not required, and many people forgo this option to save money.
Are you currently covered under a health insurance policy? Having the right health insurance will ensure that you or your loved ones will receive the care that they need regardless of what situation arises. You can use the advice that this article has provided to you to ensure that you and everyone you love has proper coverage.
By Rick Popovici
It is important to consider quality case management courses in an effort to enhance your medical career. Professional doctors and nurses will look to the training in order to provide quality health care to each individual patient. One of the problems with the training was the program was not available through traditional learning institutions. The programs were not part of an overall health care curriculum program. However, training is available through some powerful resources online. The training will break down how each individual case should be handled in terms of care. Obviously each patient will have their own need and will require a specific type of treatment. The right program will isolate the care which in turn gives the health care provider a strong understanding on the care of individual patients. The proper education and training will enhance your medical career and certification is available through the AACM Fellowship program.
For more information you might want to visit www.aihcp.org and press request information. They will inform you of their case management program and what you need to do to fulfill your educational goals. What are you waiting for? Take that first step in your new career today!
Case management courses can help you start an exciting new career.
Case management training can lead you to a better career.
I’m very happy to have a new career. I had been working as a social worker for women of abuse for over 15 years. Even though I really did love my job, I was starting to feel like it was stressing me out. I wanted to do something similar as a career, but I wanted to look at other options. A good friend of mine worked as a case manager, and she told me that her company was hiring case managers, and that they also they were doing case management training. I decided to apply to work with my friends, and to my surprise I was hired. I started my training, and I really liked everything that I was learning. Now my friend and I are both able to work together as case managers, and we both very much enjoy our jobs. I’m very happy that I made a career change, because I love working in case management.
So if you are looking for a change in your nursing career, why not look towards case management? It can be a boost your career and pocket book needs.
By Jeff Goldstein
