Foundations of Case Management
A case manager must have a broad knowledge of reimbursement methods to perform her job effectively. She must understand how healthcare reimbursement is tied to quantifiable outcomes. She must also understand the clinical and financial resources available to her patient, the eligibility criteria for receiving those resources, as well as the limitations and restrictions to the resources. When the needs of the patient and the obvious financial resources available do not match, the case manager must be aware of alternate resources available to the patient.
You will learn basic insurance coverage and principles you need to begin working as a case manager. This will help familiarize you with the terminology, principles, concepts, and alternative financial resources, creating a foundation you can build on during your case management career.