What is a financial aspect of case management?

Evaluating insurance coverage and expenses is a fundamental financial aspect of case management. This practice involves understanding the various types of insurance policies patients may have and determining what services are covered under those plans. Case managers must review patient coverage to facilitate access to necessary services while also considering the financial implications for both the patient and the healthcare provider. This evaluation helps in planning and coordinating appropriate care without imposing undue financial burden on the patient, thus ensuring that care is not only effective but also financially viable.

When case managers accurately assess and communicate insurance benefits, it enables them to advocate more effectively for patients, ensuring they receive the max benefits their plans afford. Proper financial assessment can also help identify potential cost-saving options or alternative funding sources, ultimately supporting better health outcomes.