Case Managers are in place to assist people (patients and caregivers), coordinate care, and work with your team to help you obtain resources to meet your needs. They are in a place to advocate for YOU, the injured worker, the employer, and all healthcare team members. It has been said they are the glue that keeps the healthcare system together.
Case Managers are in every segment of the healthcare system, but sometimes they are hard to find. If you see yourself in a confusing system where you need to know what is happening, ask for a case manager. They should respond to your needs and help you find your needed resources.
If you are in the hospital, the hospital case manager may discuss discharge planning to a rehabilitation center or a skilled care facility. Once you are discharged, your hospital case manager will close your file. They may make a follow-up call to ensure your care plan is in place and working for you. If you are a complex patient and need more support, ask your hospital case manager to connect you to a case manager at your insurance company. There should be continuity between each case manager you encounter, as they all should work together.
Case managers want to help you understand your condition, prevent setbacks, and find resources to meet your needs. They should also be able to support you by asking questions about your insurance company or other doctors you are working with as part of your team.
Simply put, they are in place to help you – help your family – and help you understand your condition so you can prevent setbacks and learn to advocate for yourself.
Many case managers work telephonically, but many work on-site and can get to doctors’ appointments with you so they can help you formulate questions that can address your concerns about your care.
Most case managers are nurses, social workers, physical and other therapists, and mental health professionals.
If you need help in the healthcare system, ask if there is a case/care management department, and if so, can you please see a case manager? If you have insurance, you can call your healthcare insurance company to get one assigned to you. If you are an injured worker, ask the claims adjuster to bring a case manager into the team.
Hi Anne, This is so true. As an Independent Patient Advocate I have been working with a Case Manager to help with a client to make sure all their needs are met. Together we have been able to provide the client/member with much needed coordination of care. The Case Manager works for a Benefits Administration group who has eyes on the health insurance side and I have eyes on the medical side. We share information, with the clients permission, work together to get much needed diabetic supplies, coordinate office visits, and in general get the client back on a much safer path to get her Type I diabetes back under control while providing cost savings. It is a win-win for everyone. Totally appreciate what you and other Case Managers do!
Although now retired, when persons ask me about what they should do as their next step in medical recovery, I remind them to call the toll free number on their medical insurance company card and if hospitalized, ask for a Case Manager and work with them.
– Of course, I can’t help giving them generic information, based on my years of Case Management practice, reminding them I am always here if they want to talk.