Case Management Advantages

The ever-changing landscape of health care has numerous complexities. With more varieties of care than have ever existed, patients, medical providers and insurers alike need case managers -- people who organize the delivery of care and untangle the intricacies. The success of case management in health care has led other service providers to make use of it as well. Social welfare agencies, drug courts, non-medical insurance providers and law firms also have case managers to ensure proper process, service delivery and payment.

Point of Contact

• Patients or clients can easily find themselves in a confusing world of unfamiliar processes, steps, services and treatments. In the past, an individual might have had to call different people and departments to find out about the different facets of her case. Case management gives clients a single point of contact. A case manager is a resource people can use to get answers on issues as diverse as appointments, treatments and billing. The case manager does the internal communication within an organization to get answers and returns to the client with definitive information.

Advocacy

• Case managers act as advocates for their clients. Hospital case managers work on behalf of their facilities for patients and their families to get insurance approval and cooperation for patients' medical treatments. Insurance companies hire case managers to watch over their interests. With health insurance, nurse case managers work to ensure their companies pay only for medically necessary and appropriate treatments. Social workers managing cases advocate for their clients' needs, whether they be financial, such as getting welfare assistance, or finding emergency resources, such as getting clients to shelters for battered women.

Coordination

• It often takes many people and departments working together to achieve goals. Case managers communicate with various members and departments of an organization to ensure all do their part to deliver the correct services properly and promptly. For example, a case manager in a skilled nursing facility participates in meetings with nursing staff, administrators, patients, families, social workers and rehab therapists to develop a concerted plan of care for each patient. Case managers in law firms ensure attorneys, paralegals, couriers and clerks all do their part to keep cases moving in a timely manner.

Quality Assurance

• Although organizations expect each team member and department to do the best job possible every time, they also know that's not always what happens. Case managers provide another set of professional eyes reviewing each case. They catch errors, ask questions and raise concerns that ensure that service providers do their jobs correctly. In many cases, case managers not only assure quality, but challenge professionals to do their best work.