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In this section, crisp, compact articles are directed to the professional pursuits of today's busy case manager. Ranging from advice from clinical leaders to explorations of the prominent trends of the industry to best-of examples of programs and initiatives from around the country, this section will orient you with the most salient ideas and tendencies in the practice today. Begin below, or start by exploring a category to the left.
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Profession
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Tuesday, 02 June 2009 15:22 |
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 In this sit-down with an industry leader, we direct the spotlight to Donna Wallace, MSW, LCSW, who developed a family counseling program with a preventive orientation to address the social and emotional needs of students who are deaf or hard of hearing in Broward County, Fla., schools. In addition, Donna has a private practice serving adults who are deaf. Anne Llewellyn talked with Donna about her work. Ms. Wallace may be reached at
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Q: Can you share your role as a social worker in this specific segment of health care?
A: Social workers show up in a variety of settings these days — in hospitals, nursing homes, mental health agencies, schools and businesses. As the world becomes more complex and demanding, the pressure to stay the course and to produce as much or more than those around us intensifies. This is especially true in our schools. The job of educators is to prepare the leaders of tomorrow. Federal legislation in the guise of “No Child Left Behind” attempts to ensure that all children are educated and ready for the challenges ahead.
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Advice
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Tuesday, 02 June 2009 15:07 |
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 In this edition of Ask the Expert, Teri Treiger, RN-C, MA, CCM, CCP, CPUR, a Clinical Product Manager at McKesson Health Solutions and forthcoming President-Elect of CMSA, discusses the importance of Current Procedural Terminology codes as they relate to the practice of case management.
Current Procedural Terminology (CPT®) is a code set maintained and annually updated by the American Medical Association (AMA). Each code is five digits in length and describes a medical, surgical, or diagnostic service delivered by a health care provider. Created in 1966, CPT codes provide a common framework for communication and reporting purposes. This code set was designated as the national standard for use by physician and health care professional services by the Department of Health and Human Services in 2000. With a few exceptions, in the fall of each year, the AMA issues a revision of the code set. The changes become effective as of the following January.
Q: Why should CPT codes matter to case managers?
A: Presently, there is no specific code(s) dedicated for use by case management professionals, the lack of which carries ramifications. Perhaps the most important goes to the ability to prove the value of case management within the health care system. Because there is no consistent, accumulated data regarding case management activity or cost, uniform analysis and reporting is extremely challenging. Another impact is that case management professionals do not have a dedicated CPT code with which to submit claims to third-party payers for services rendered.
Q: Do CPT codes exist that pertain to case management that could be used?
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Profession
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Written by Elizabeth E. Hogue, Esq.
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Thursday, 30 April 2009 19:38 |
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Discharge planners and case managers are likely to encounter instances in which home care, hospice, and home medical equipment (HME) providers state that they cannot accept patients because they are “unsafe” at home. The use of this term may be confusing to discharge planners and case managers. What is it about patients’ homes that makes it “unsafe” for them to receive services there? Aren’t all patients appropriate for home care?
First, discharge planners and case managers may not have provided services in noninstitutional settings. If so, it may be difficult to make a crucial distinction between institutional care and home health services.
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