The Hospital Case Management Orientation Manual

The Hospital Case Management Orientation Manual is a comprehensive resource that supplements initial training for new case managers. This book explains what to document, where to document it to ensure appropriate level of care and reimbursement, and how to avoid unnecessary denials.

This book s focus is utilization management, discharge planning, and relevant CMS regulations. It can help new case managers learn how to perform their jobs effectively on their own time. It can also serve as a wide-ranging resource for more experienced case managers, particularly those whose training was less than adequate.

Table of Contents

Chapter 1: Case Management Basics
Chapter 2: Factors Influencing Case Management and Its Processes
Chapter 3: Healthcare Funding
Chapter 4: Utilization Review and Utilization Management
Chapter 5: Letters, Denials, and Appeals
Chapter 6: Care Coordination
Chapter 7: Transfers, Levels of Care, and Transition Planning
Chapter 8: Home Health, Hospice, and Other Home Care Services

Who should read this book?

- Case manager
- Director of case management
- Clinical documentation specialist
- Director of clinical documentation improvement
- Chief financial officer

• The Leader's Guide to Hospital Case Management (Jones and Bartlett Series in Case Management)
• The Hospital Guide to Contemporary Utilization Review
• CMSA Core Curriculum for Case Management
• Discharge Planning Guide: Tools for Compliance, Fourth Edition