[hoolahan]

Anyone out there practicing independently? I would like to do this eventually, but I do not have workman's comp experience, and it seems that this is what they want.

Any tips?

[LasVegasRN]

Disability management is the growing area in case management. Even if you do not specialize in workers comp or disability, it's still an area that case managers are expected to have some knowledge in. On the same note, I'm not a peds nurse. Could I case manage a peds case? I know how to move a client through the health care continuum while effecting cost containment and utilizing community resources where ever possible, but I'd be at a great disadvantage. Thank goodness there are avenues for most of our backgrounds.

I think as long as you know the basics, you'd be fine. But if you want to go independent, I would highlight and stick with the background you have the most knowledge in. There are independents who advertise their expertise, and are doing very well in those selected areas.

I'd see what is in demand in your area. What is the greatest need? Psych? Peds? Work Comp? Trauma patients? If the need matches your area of knowledge, chances are you'll have a good chance at succeeding independently.

Good luck!

[hoolahan]

Thanks Las Vegas! But, how do you go about getting business? Do you contract with insurance companies? I don't have a clue where to begin. I did cardiac nursing for years and now HH. Any ideas?? Thanks!!

[LasVegasRN]

You might want to start with cardiologists you have had contact with. One of the biggest sources of frustration with physicians is trying to handle difficult patients - they need a liason for the insurance company, family, consulting providers, etc. You can be that person. I'm sure you can think of "cardiac cripples" that just seemed to stagnate because there was no coordination of their care, you could be that person. If you can communicate your value to the physicians, then sometimes they will request from the payor source that they hire a case manager. That's one method to get your foot in the door.

I'll think of some more.....

[hoolahan]

Great ideas. I would love to be working with cardiac pt's and the elderly. Maybe I should contact some insurance companies and contract with them too.

I just applied to take the CCM exam. What an unbelieveable process. I am in the process of gathering letters of support from all my employers. Hopefully they will accept that, and look at my many diff jobs as a plus instead of a negative. I still don't know yet if they will deem me eligible to take the exam. Keep your fingers crossed for me.

[LasVegasRN]

No problem! Let me know if you need some study pointers.

When you contact insurance companies or payor sources, they are going to want to know HOW you are going to be able to help save them money. That's the bottom line. Be well prepared to answer that question. You'll want to have, down pat, how you determine savings, how you bill for your time, how you promote cost saving measures and gauge your effectiveness in moving the client along the continuum. Remember, you are selling yourself and your expertise.

[hoolahan]

In other words, they want to see outcomes. How can I show them any when I haven't been independent before to have any outcomes? Any thoughts? And thanks for all your suggestions. Any boks on this out there I wonder?

Did you get your CCM Vegas?

[LasVegasRN]

Hey, I love case management and try to promote and uplift whenever I can. Your welcome.

I haven't started an independent business from scratch, so I can't really answer the questions about showing outcomes. My best guess is to show how you would determine and base your outcomes on.

Yes, there is a book I recommend, The Case Manager's Handbook, by Catherine M. Mullahy. It's also an excellent study tool for the CCM exam.

I took the CCM in 1999 and passed. It's definitely a good thing to have.

I'd also recommened www.cmsa.org for more resources. If there is a local chapter in your area, go to a meeting!

[hoolahan]

Hi LV, I bought that book, and I am about to start it, and also another book by her, a collection of CM ariticles, "recommended readings." And, I got the core curriculum. I hope I can pass this thing, I've heard it's a wicked test.

Maybe I'll figure out some more info after I finish the studying too.
Glad you're here!! And I love your Krusty avatar!

[LasVegasRN]

It's a bear, for sure. Hard to study for.

Hints - know your disability laws. Especially ADA guidelines about employees rights and employer responsibilities. Know about Longshoreman's Act, ERISA, URAC, COBRA, etc. Know about FMLA, who qualifies, what rights it gives employers and employees. Those are just a few...

Good luck, and thanks, I love these boards!