The Case Manager's Handbook Chapter 12 Flashcards
1
Q
Negotiating Skills
A
Aquired, requires thought. Fulfill patients needs in a cost-justified manner; pursue high quality at affordable cost.
2
Q
Carve out services
A
Stop-loss carrier might have negotiated separately with Center of Excellence.
3
Q
Prompt pay
A
2-4 weeks within arrival to claims department
4
Q
Tracking negotiated payment
A
Case Manager becomes “clearinghouse”; communicate with provider and payer source. Bottom line, method needs to be consistent.
5
Q
Cost benefit analysis writing
A
Best performed by case manager
6
Q
Cost benefit reports
A
Reflects Quality Assurance; can be empowering for case manager.
7
Q
Other ways to measure quality assurance
A
Patient Satisfaction Survey
