Medical Case Management Explained

Although many have heard of nurse case management before, people are often unaware or misinformed on what it actually is and what role it plays in the medical care process. Understanding case management nursing will help you understand not only the processes of medical care as a whole, but also how specific diseases or patient problems are managed differently than others, while still providing the care needed.

Brief Description

In short, case management nursing is a medical cost containment service focused on developing a comprehensive care plan, for a specific client, with a specific set of needs, over a long-term period. Most often case management is needed for patients with long-term diseases or injuries such as AIDS patients, workers compensation patients, and even children with long-term conditions. Most case management nurses specialize in a specific area of treatment. This ensures a comprehensive treatment plan for the patients and a more efficient diagnosis and treatment period. It's also common for there to be on-site case management nurses at some specific treatment locations and care facilities.

Function

The basic function of such services is to make sure the care that is needed is received on time and most effectively to meet a patient's and care provider's needs. As simple as this may sound, it's a very complex task. To create the most beneficial cost containment plan, with the utmost results, nurse case management directs and coordinates treatment over the course the entirety of the treatment period including PPO channeling and specialty referrals. For many illnesses such as cancer this can be a lengthy period of treatment including primary care visits surgery, chemotherapy and follow up care. Others such as such as workers compensation and surgery patients may have a smaller period of treatment or may require different considerations for their injuries or health problems.

Proper management can help optimize treatment time as well as recovery time, reducing expenses for care providers and getting those being treated back to work and living normal lives faster. Effectively communicating between patients, insurers and providers ensures comprehensive and timely care and is an invaluable asset to the medical industry as a whole. Undoubtedly as technology and comprehensive treatment continues to improve in the future case management could become a feature of medical care that follows you not only through the term of treatment but post treatment, especially for children who continue with conditions or health issues as they grow.
About this Author

David Hutton serves as an internet marketing source for CompComplete, a medical bill review and Managed Care Services provider in Lawrenceville GA.