d'cm

d'cm

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All Content by d'cm

  1. Help, I'm in over my head!

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

    The resources available to your member are totally benefit/ State/ local specific so it is hard to offer suggestions without more detail. That being said, the facility has, by accepting them in...

  2. AMA Discharges

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

    If you accept the opinion of some experts that 200,000-400000 people are injured in hospitals yearly, the safest place for anybody able to get themselves up and out is

  3. What makes a good nurse case manager?

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

    This is a good question. I would have to say that what makes a good CM might depend on who is asking. Employers may think what makes a good CM is one who maximizes their revenue, C(their)A, and...

  4. Falsification of medical records

    d'cm replied to psunsg1975's topic in Case Management

    I am not a manager but my work in an insurance company requires the review of other case managers documentation and I see falsification on a daily basis. In fact most of my career involved chart...

  5. Peer to peer

    d'cm replied to RN010101's topic in Case Management

    It might not make any difference to the doc in the least. They get paid the

  6. Peer to peer

    d'cm replied to RN010101's topic in Case Management

    "Needles to say". LOL. but to answer your question:

  7. Observation Unit

    d'cm replied to newRN_2014's topic in Job Search, Interview, Resume

    Most hospitals do not actually designate a separate unit for observation which is a Medicare payment status for patients that do not meet admission criteria. Observation is considered "outpatient"...

  8. CM and MD communication

    d'cm replied to RN010101's topic in Case Management

    Grntea, what you say and how it is said truly depends on the culture of the hospital and the individual physician. I have had the exceptional experience of working in 2 of the top 10 worse hospitals...

  9. CM and MD communication

    d'cm replied to RN010101's topic in Case Management

    RN010101, I also found those conversations the most difficult things a hospital case manager has to do especially if your hospital is still dependent on independent practitioners for admissions....

  10. What game show describes your workplace?

    d'cm replied to Brian's topic in Nurses Rock

    "What's my Line ?" I work in managed care for a huge company and we are always guessing who is supposed to be taking care of

  11. Ordering DME in the ED

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

    My experience is similar to MBARNBSN which makes me think the issue for the OP was the DME provider market. Here in NJ it is highly competitive. I have provider reps in my face daily trying to get me...

  12. new to cm

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

    This question has been batted around many times. Search the site for ideas. I do think that your ER experience would be an excellent background for an appeals / denials position. There are firms...

  13. Appeal RN

    d'cm replied to Sue555's topic in Case Management

    My experience with MCO appeals is that it is nothing like CM except that you are looking at medical records from a UR pov. Basically you just summarize the case for the medical director's review and...

  14. Can FNPs work in case management?

    d'cm replied to correr82's topic in Case Management

    BSN MSW combination should be a slam dunk for a CM position. Just make sure they pay you on the RN scale not the

  15. What's the nicest thing anyone has ever said or done for you?

    d'cm replied to Brian's topic in Nurses Rock

    Nicest words I've heard: "You're

  16. UR by CM a conflict of interest?

    d'cm posted a topic in Case Management

    Grntea, posted in another tread: "In our state it is illegal for case management to do UR. Third party administrator (TPA) companies sometimes have two separate divisions for UR and CM, but it's a...

  17. Can anyone give me info about their experiences as a Case Management Nurse?

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

    That is very interesting and worthy of new

  18. Can anyone give me info about their experiences as a Case Management Nurse?

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

    Case managers that work from home usually work for an insurance company. Obviously, hospital case managers can't but the core of what they do is same: Assess needs, make a plan, discuss that plan...

  19. Tell me honestly how you like your career as a case manager

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

    I would have to say that case management has been as close to a perfect job for me as I could conceive. Yes sometimes there is too much work and it is stressful, but not that "OMG I going to kill...

  20. So, you think you want to be a cm..

    d'cm posted a topic in Case Management

    I opened up an email this morning from a recruiter looking to fill a hospital case manager spot. It reminded me why I would never consider working in a hospital again because, believe it or not, they...

  21. So, you think you want to be a cm..

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

    Are you asking what a Physician Advisor is

  22. Is nursing really that bad of a career choice?

    d'cm replied to alyssajeanette's topic in Nursing Career

    Really. We have here a site that provides nurses from every conceivable specialty describing their experiences, feelings, opinions and expertise without restrictions. What would you suggest

  23. Community case managers...do you ever miss the hospital?

    d'cm replied to ruralgirl08's topic in Case Management

    I think you will be surprised how intense home care nursing can

  24. Case Management Model

    d'cm replied to julie1212's topic in Case Management

    Here in NJ things are pretty much the same, nurses do UR and d/c planning to home and SW d/c to SNF. I'm curious as to what changes you are seeing that would require - and not actually dictate -...

  25. What type of Nurse Case Manger are you?

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

    "The p.o.'d, frustrated, can't believe the how dysfunctional our health care system still is"