Catastrophic

What is a Case Manager?

 

"Case managers are advocates who help patients understand their current health status, what they can do about it and why those treatments are important. In this way, case managers are catalysts by guiding patients and providing cohesion to other professionals in the health care delivery team, enabling their clients to achieve goals more effectively and efficiently.” (Case Management Society of America, CMSA)

Purpose of Case Management

  • To provide objective information as needed for purposes of treatment.

  • To maximize efficiency in the utilization of available resources.

  • To work collaboratively with the patient, physician, adjuster, attorney (if applicable), family/significant other and providers to implement a plan of care which meets the individual's needs.

  • To promote the optimal recovery through effective and efficient use of resources.

Goals of Case Management

  • Ensure that all medical and rehabilitative services are coordinated in a timely fashion while keeping cost efficiency in mind.

  • Assist clients to achieve the maximum level of recovery and function by advocating for medical and rehabilitative services.

  • Educate clients to self-advocate and make decisions regarding their care as they are able.

  • Communicate with client, treatment team and family to ensure that care is goal-directed and coordinated to optimize recovery.