CASE MANAGEMENT DEPARTMENT

Trouble Shooter, Patient Advocate

A Case Manager is the trouble shooter working with all the medical staff to secure the best outcome for each patient.

The Case Manager audits charts for criteria for admission daily Monday – Friday based on the standards set by MC that all insurances, Medicare, Medicaid and private payors follow for making sure a patient receives appropriate care. These standards dictate whether hospitalization, home care, nursing home or rehabilitation are the appropriate level of care. The case manager meets with the Doctor to get more information into the chart for authorizations or admission criteria.

Every patient that has a private pay insurance has to have an authorization for admission. The Out Patient/Registration Department and Case Management work together to secure these in a timely manner. It is so important that each patient bring their current insurance information to the hospital. If they present the wrong information an authorization may not be obtained, it may take an additional 24 hours to get that authorization.  The Case Manager also helps to arrange Durable Medical Equipment for a patient upon dismissal.

The Case Manager may help families with such documentation such as “Out of Hospital DNR”, “Advance Directives to Physicians” and “Medical Power of Attorney”. The Case Manager can only provide assistance with these forms to patients that are of sound mind. All others are referred to local attorneys. The Case Management Department has worked closely with several local attorneys to keep their forms updated with changes in the terminology. Any person interested in completing the forms may contact Case Management Department at (806) 872-5727 ext. 3154 to set up an appointment. Please bring phone and addresses for three persons to be listed on the “Medical Power of Attorney” to this meeting.