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
How Case Management Training Can Help You Reach That Next Level!
It’s no secret! Case management training is great!
Case managers play an important role in the physical, mental and social well-being of many people today. They may take many forms, from the social worker helping a disadvantaged child find services to a person helping coordinate medical and social support services for the developmentally disabled. However, one of the most common types of case manager is the medical one. These professionals generally work in a hospital or hospice setting and are responsible for coordinating care and seeking out options for an ill or injured patient. They are also responsible for patient advocacy. In other words, they speak up on their patients’ behalf in order to get the best care possible. Case management training is typically offered to Registered Nurses, although other individuals may qualify as well. A good case manager should be certified by a professional board and pursue continuing education in order to maintain their certification. Case managers provide a valuable service in today’s healthcare system.
If you feel you have what it takes to become a case manager then you need to find a way to fulfill your educational goals. You should start your quest at aihcp.org. They have an excellent online case management program.
As a recent college graduate, I am really amazed at how much they do not teach you in school. I am a civil engineer and I have been at my first job for about three months. I have used very little of the complex math that I had to learn as an undergraduate and I feel like I wasted a lot of time and effort learning that stuff for nothing. My job has spent a lot of time and money teaching me things that I feel like I could have learned in school instead. It is not just me, either. Everyone else who the company hires right out of school has the same problem. This is not even something that is an engineer problem either. My friend is a new nurse and says she wishes her program would have taught her something about nursing case management because her job requires it.
Somecase management programsjust want to push you out the door. Not AIHCP! They allow you to take your time and study at your own pace. A good online program will help you learn and advance when you are ready. Insuring that you learn the material instead of just memorizing it.
More and more people are living longer, and as they do they encounter additional health challenges. This means there is a much greater demand for trained health care professionals now than there ever was before. The real need is for skilled nurses who can manage individual cases, working with doctors and technicians to enable better outcomes. Nursing case management is a growing field, requiring dedicated, caring nurses who can see the whole person, not just a set of symptoms, and lead the patient down the path to wellness. This profession needs people who are tender yet tough minded, able to make the decisions necessary to ensure that doctor’s orders are followed correctly, and to lay out treatment plans that can be followed with confidence. If you think you have what it takes, this is a career option you should explore, allowing you to really provide high level care and help to all. If you are a nurse looking to enter the nurse case management field then you need a good education. Many case management programs are available online and allow studying at your own pace. AIHCP
Care Management professionals hard at work!
There is a change underway in American medical care, shifting the focus to more of a care management system where a qualified medical worker will monitor a patient during the course of their treatment. Many Americans have chronic health problems that can last years, decades, or even their entire life. A care manager is a medical professional that has been trained in helping patients through this long and difficult process by taking a more holistic approach to patient welfare. Rather then focusing care on a single problem, the care manager will, instead, view the treatment process as a crucial step in the long term overall health goal for the individual. As the Baby Boom generation continues to age the demand for specialists who can manage long term health care is expected to increase dramatically in the coming years. It can be a challenging, and rewarding, career for the right people.
Care Management can also be a great way to further your nursing field career. If you are afraid you do not have the time to study, then try an online route to success. Many online care management programs allow you to study at your own pace.
Case management is the process of matching the resources available to the needs of the individual patient in such a manner to enhance the quality of patient management and patient satisfaction. Nursing Case Management has held a relatively low-profile position in the field of health care till the latter half of the 20th century. The cost effectiveness and continuity of patient care is increased through utilization review and discharge planning. Case management nurses form an important part of the healthcare team. Nursing Case Management ensures that a patient receives the most effective health services by being in touch and communicating with the patient, the doctor, the health care providers, and the other allied health care services such as insurance. The duties of a case management nurse include the following: They act as care coordinators between the doctors, therapists, dieticians, specialists, etc., and develop an effective working relationship. They record the symptoms, perform the diagnostic tests, and collect all details about the vital signs of the patient. Promote the efficient and effective utilization of clinical resources. They constantly communicate with the doctors and insurance companies. Ensures adequate care for the patient during the hospital stay and facilitates timely discharge. Conducts review for appropriate utilization of resources and services from the instance of admission of the patient through discharge. Makes sure that the patient does not get more than necessary care. Facilitates a relationship between the family and the patient to enable them to take informed decisions. Case management nurses are RN’s who have undergone specialized training or have completed certificate programs in case management. On completion of the program the certificate is issued if the candidate has a current valid RN license, has an experience of two years as a full-time RN, and has worked for 2000 hours as a case management nurse in the last three years. Though the additional training is not always compulsory, jobs in specialized health care settings do require the specialty training.
Skills required to be a successful case management nurse include all skills required of a medical job, communication skills, the ability to respond quickly to medical emergencies. The case management nurse is expected to gain knowledge about diagnosis related group codes (DRGs), develop critical thinking, be observant and keen and improve the ability to analyze. Certified case managers are always paid a higher salary than other nursing professionals. A case management nurse earns an average salary between $55000 and $75000.
The job of a case management nurse is much in demand as hospital stays of patients are becoming much shorter. Role of a Utilization Review Nurse A utilization review nurse reviews individual medical cases to ensure that they are getting the most effective care. Such utilization review nurses work for the hospitals and sometimes for insurance companies in an advisory capacity and decide whether specific care for the patient is to be approved or not. They balance the needs of the patient to make the entire episode of care to be one that is cost effective, enforce policies and are instrumental in providing care that is suited to the needs of the individual patient. Working as a utilization nurse may involve situations when the cost issues have to be weighed against the obligation of providing care to the patient. They may have to approve or deny a specific method of treatment, a diagnostic test or a medication to the patient as per organizational guidelines. Utilization review nurses review requests pertaining to hospitalization of patients, medical imaging tests, recommended medical procedures and also whether the cases meet the standards for reimbursement of claims by the insurance companies. They ensure that patient care stays at specific levels and make adjustments in case of changes that may occur.
A utilization review nurse must be a qualified RN, at the baccalaureate level, and must have some minimum experience in the field of case management nursing. The skills associated with this job includes the ability to work under stress, be able to work independently without supervision, keen observation and attention to detail, be able to work with large amounts of data, ability to analyze and decisiveness. Utilization review nurses earn an average salary of $75000 per annum, a pay that is higher than what most RN’s earn.
If you are interested in Case Management Certification, please review the program.
We are witnessing a growing trend in health care delivery. Providers of health care and insurers are starting to work together more closely to improve the quality of care and hold down unnecessary costs. This is not totally new as such processes have been in place for a long while through nursing case management systems, albeit sometimes in adversarial postures. What is new is that executives are finally understanding better the need for collaboration and cooperation in the delivery of care. This article is an example and provides promising insights.
By: REED ABELSON
The New York Times
Access article: click here
To learn more about case management certification programs, click here.
