The Case Manager's Handbook / Edition 5

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More About This Textbook

Overview

Written by renowned author Catherine Mullahy, The Case Manager’s Handbook, Fifth Edition is the ultimate how-to guide for case managers. This practical resource helps case managers build fundamentals, study for the Certified Case Manager (CCM) exam, and most importantly, advance their careers after the exam.

Written for all professionals in all practice settings in case management, it uses real-life examples and an easy-to-read, conversational style to examine the case management process while presenting practical procedural information. An excellent daily reference and training guide for new case managers and seasoned professionals in various setting, The Case Manager’s Handbook, Fifth Edition is the “go-to” resource for facing the day-to-day challenges of case management, especially as the nation navigates through the many changes introduced by the landmark Patient Protection and Affordable Care Act.

Significantly updated and revised, it contains eight new chapters:
* Hospital Case Management: Changing Roles and Transitions of Care
* Patient Centered Medical Home, ACOs, Health Exchanges
* Evidence-Based Practice
* Public Sector Reimbursement
* Predictive Modeling
* Pain Management
* Health Technology, Trends, and Implications for Case Managers
* The Affordable Care Act of 2010: Implications for Case Managers

Included with each new print book is an Access Code for a Navigate Companion Website for students with objectives, multiple choice questions, and bonus appendices.

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Product Details

  • ISBN-13: 9781284033601
  • Publisher: Jones & Bartlett Learning
  • Publication date: 6/20/2013
  • Edition description: New Edition
  • Edition number: 5
  • Pages: 875
  • Sales rank: 137,038
  • Product dimensions: 6.10 (w) x 9.10 (h) x 1.90 (d)

Table of Contents

Foreword
Preface
Acknowledgments
Pt. I Profile of a Case Manager 1
Ch. 1 The Case Manager as Catalyst, Problem Solver, Educator 3
Ch. 2 The Case Manager's Universe 25
Ch. 3 Insurance Providers and Administrators 39
Ch. 4 Insurance Lines and Health Benefit Plans 47
Ch. 5 Legal Responsibilities of the Case Management Profession 77
Ch. 6 Ethical Responsibilities of the Case Management Profession 117
Ch. 7 HIPAA: The Health Insurance Portability and Accountability Act 145
Pt. II Case Management Procedures 165
Ch. 8 Communications 167
Ch. 9 The Case Management Work Format and Process 193
Ch. 10 Integrated Case Management: Preadmission, Concurrent Review, Utilization Review, Disease Management, and Case Management 299
Ch. 11 Working Effectively with Claims Departments: Case Managers in Consulting Roles 345
Pt. III Case Management Administration and Financial Considerations 375
Ch. 12 Financial and Quality Assurance Reporting 377
Ch. 13 Managing a Case Management Department: Your Role as Department Head or Independent Case Manager 463
Pt. IV Trends and Opportunities in Case Management 521
Ch. 14 Case Manager Credentialing 523
Ch. 15 Cultural Issues 535
Ch. 16 Behavioral Health 543
Ch. 17 Dying in America 549
Ch. 18 Industry Directions 569
Pt. V Case Management in Action: Cases in Profile 581
Ch. 19 Care at Home 583
Ch. 20 Managing a Long-Term Case 599
Ch. 21 Techniques for AIDS Cases 615
Ch. 22 Public Sector Case Management 635
Ch. 23 Cases in Profile 643
App. A: Additional Resources 675
App. B: Glossary 695
App. C: Case Management and Health Care Web Sites 719
Index 723
About the Author 749
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