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From The CriticsReviewer: Roberta M. Conti, PhD, RN, CCM (George Mason University College of Health and Human Services)
Description: This book focuses on case managers working for third party payers and insurance companies.
Purpose: Its primary purpose is to provide definitive practice guidance for payer-based case managers. Proposed objectives are to provide training, program establishment guidelines, and comprehensive and fundamental information. These objectives attend to the core competencies required of case managers in payer-based systems. The content is addressed in a clear, comprehensive manner.
Audience: The authors' primary audience is novice case managers working in the payer-based model of case management. Secondary audiences include experienced case managers and insurance professionals. This book could be used in continuing education and in academic courses.
Features: The authors comprise an interdisciplinary group representing nursing, vocational rehabilitation counseling, and clinical psychology. Their educational preparation, credentials, and experience indicate they are credible experts. Illustrations are organized across four appendixes and include example forms and communications used in case work, as well as example practice criteria. They provide good examples for novice case managers. However, the formats do not easily allow for application of information technology in data collection. References are current and include appropriate publications. The table of contents clearly identifies major sections and subsections. Heading structures assist the reader to easily identify content focus. The book's softbound cover, size, and shape make it easy to use. Unique features include a well-done glossary, attention to vocational rehabilitation, chapter end suggested readings, and use of a cumulative numerical footnote system.
Assessment: This is a well written, payer-based practice guide of particular usefulness to novice case managers. Comparative examples are an especially effective writing technique. The book is comprehensive in its scope, including topics like ethical practice. Practicing case managers in payer-based models, insurance professionals, libraries, and educators who wish to use it as a supplemental text should buy it.