Case Managers coordinate patient care across the continuum to assure quality of care in a fiscally responsible environment.
We collaborate with the physicians and healthcare team to set individual goals for our patients. We obtain information through patient assessment, medical records, and family interview when appropriate. We arrange a variety of services to support a safe transition to the next level of care. This may be home, rehabilitation, or tertiary care.
We provide concurrent clinical information to insurance companies to obtain authorization for hospital services. We manage denials through appeals.
We are responsible for clinical documentation improvement and collaborate with the physicians to ensure optimal reimbursement and prevention of denials.