Case Management

Identify your department's revenue cycle risk; ensure adequate staffing

Case Management Monthly, May 1, 2010

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“Case managers are like Velcro—every time an issue comes up, the administration throws a piece of cotton at us,” says Tina Davis, RN, MS, CMAC, consulting associate at The Center for Case Management, Inc., in Wellesley, MA.

Case management departments now perform several additional functions (e.g., managing core measures, clinical documentation improvement, discharge planning) with the same staff it had 10 years ago when it only did utilization review, Davis says.

If your case management department looks at all the ways it influences the revenue cycle, it also needs to determine whether it has the staff members needed to perform those tasks, Davis says. Otherwise, what could have been an asset is now a potential revenue stream risk.

Specifically identifying which disciplines you need to address those risks to will help build an understanding of your staffing needs.

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