Case Management, Elder Care Management, Life Care Plan, Medical Consultation

Initiating the Case Management Process

 March 4, 2021

By  Deborah L Weiner Katz, OTR/L, CCM, CLCP

Case management is a unique profession. In fact, it is not a profession so much as it is a specialization, a hub where various disciplines intersect. People sometimes wonder whether they would benefit from the services of a case manager.  Here is a closer look at the initial meeting between a case manager and his or her client. This may provide the reader with insight into how the process works to help determine who benefits from these services.
People in need of services are referred to a case manager in different ways. In an acute care setting, individuals are typically referred by a physician, nurse, or social worker. Otherwise, the case manager will meet with almost every new admission and will perform an assessment.

Some case managers are community-based. They receive referrals from primary care providers or specialty care providers. Sometimes, regulatory obligations related to Medicare or Medicaid might require the services of a case manager.
An independent case manager helps families and individuals who are not receiving services within a medical system where their care is well coordinated. Individuals with complex medical or rehabilitation needs often require assistance to bridge the gap between hospital and community-based care. Elderly individuals or people with chronic, acquired, or inherited conditions may also require assistance from a case manager.

The case manager meets with individuals and families to assess their needs during an intake meeting. Based on an individual’s health and living situation, the case manager will determine how to assist an individual to live as independently as possible. The case manager looks at insurance and financial resources to assist in identifying resources. It is important to assess the client’s physical, emotional, and cognitive functioning in addition to their physical needs.

Once this information is gathered and reviewed, the case manager’s job is to recommend resources he or the client could benefit from. The case manager assists in providing an explanation of services recommended. Written instructions are provided when needed and the case manager ensures service implementation occurs.

While you are in a hospital setting, you may be assigned a case manager. It is a little more difficult when you are living in the community. Do not be afraid to call a company providing these services. Most companies will provide initial information at no charge and will help individuals understand the process and the cost.

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