snotpikkr

snotpikkr has 30 years experience and specializes in oncology, med surg.

Latest Activity

1. Patient Right to Appeal Discharge

   snotpikkr replied to d'cm's topic in Case Management

   I can't answer that question, but there is a customer service number for every patient's own insurance that they have the right to call. We have had HMO patients refuse to be discharged and go that route, but the Patient Right to Appeal Discharge per...

2. Patient Right to Appeal Discharge

   snotpikkr replied to d'cm's topic in Case Management

   This has been in effect in CA for over a year (feels like it if not..) where the patients have the right to appeal their discharge. Upon admission, all Medicare and senior managed care (Mcare elig) patients are given the Important Message from Medica...

3. Interqual?

   snotpikkr replied to Ginger35's topic in Case Management

   I have trained many nurses from the floors. In my opinion, as long as you have a good clinical background for the area you will case manage or coordinate, you'll be ok. Interqual will be another thing your trainer will show you how to use. Ours is bu...

4. Problems encountered with DMs

   snotpikkr replied to luvmyworld's topic in Case Management

   My mistake, Dria. The first post I read did not state she worked for an insurane company so I offered my opinion, which is what this is for.

5. Problems encountered with DMs

   snotpikkr replied to luvmyworld's topic in Case Management

   We as acute hospital case managers don't routinely call the patients after discharge- we rely on the health plans to do that- it is their responsibility to follow up and case manage the patients. We encourage and sometimes make the follow up appointm...

6. Interqual?

   snotpikkr replied to Ginger35's topic in Case Management

   IQ is not very patient friendly, that's for sure, and that's what we use at our hospital, however when a patient doesn't meet the criteria, our physician advisor overrides the criteria. Everyone including Medicare knows that the criteria is not alway...

7. Yeah! I got my first CM Job!!!

   snotpikkr replied to lisa41rn's topic in Case Management

   Congratulations! What I tell my staff- No one dies because of the paperwork you do. Your job is never done in a day. When it's time to go home, you need to go home. Being a Case Manager is stressful enough without adding unnecessary stress to yours...

8. Problems encountered with DMs

   snotpikkr replied to luvmyworld's topic in Case Management

   Welcome to the world of frustration and rebound patients. You have to know that what you did on the last discharge will have no impact on the patient for his/her readmission. When a patient is noncompliant, there's little you can do to help or teach ...