dria

dria

home health, peds, case management

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All Content by dria

  1. well said!! i agree that the current system isn't working...and i've left it up to far greater minds than my own to figure it out. your ancetdote serves well to support my position that insured...
  2. Kaplan's program for Case Managers

    please understand that while kaplan provides "a" certificate in case management, it is not the ccm credential. rather you get a certificate signifying that you have completed their course. in order...
  3. i am not aware of any health plans in the us that require prior authorization for services provided during an inpatient stay. outpatient based services are a different ballgame; it is impossible to...
  4. your experience has less to do with corruption on the part of the insurer than a misunderstanding of the exact issu, and a failure to understand the terms of your health coverage. most health plans...
  5. Rn Case Mngr Position With Ccm Preferred?????

    what i am doing is to work off a test bank cd....hit the areas i'm not familiar with....know the definitions of the glossary....review the regulations..... i'll let you know how it work
  6. Nurses not following doctors orders

    i think the op clearly excluded from this discussion orders that may poentially result in harm to the patient and was refrring to appropriate orders that are simply being ignored for no apparent...
  7. Transfering pt to Long term facility

    i think that all the previous posters have made good points in their responses. obviously, it is never appropriate to be rude. what i believe the issue to be is a disconnect between the the types of...
  8. Disturbing incident in triage .....

    personal experience does not make one a subject matter expert. the research clearly indicates a genetic implication to mental health disorders. the research also clearly indicates a difference in...
  9. I didn't do NUTHIN', I swear!!!

    ditto to what everyone else said...he had a terminal illness...you didnt "do" anything but make his last days better.... i remember how difficult it is to lose a pt in hh... heck...i'm doing...
  10. Anyone ever try working 60 hours a week?

    i worked 12mn-12n for about a month in private duty due to some staffing problems. i'd tell you how it was....but i honestly don't remember anything that happened during that month!!!!!! be very...
  11. let me second what jjjoy said...take that free money and run !!!!!!!!!!!!!!!!!!!!!!!! another way to look at: for every dollar you put away, you get a dollar from your employer, plus roughly 33 cents...
  12. certified managed care nurse (CMCN)

    ccm is not always a required credential in the arena of insurance based case management....i can think of three national insurance companies hiring in my area that do not require the ccm as a...
  13. such a confusing situation- long-ish

    get a ride to your appointment on the 24th. have your ride drop you off at the front door. take 15 minutes to get out of the car, then hunch over, hobble and limp straight into a wheelchair. tell...
  14. how to get started in CM

    cm isn't a job that requires a certain career track. i think the best thing you can do is to take jobs that interest you and get a broad base of nursing experience that way....my colleagues come from...
  15. certified managed care nurse (CMCN)

    thanks for the link...i just checked it out. i have to tell you i find it really screwy that one of the requirements for certification is completion of their $300 home study course, no wait....it is...
  16. certified managed care nurse (CMCN)

    i honestly have never heard of cmcn...ccm seems to be the most recognized certification in this field. you mentioned that most of your co-workers have this...is there a particular reason why? on the...
  17. NO weekends,puhleaseee!

    insurance work is good for "banker's hours"....case management, precertification, clincal coverage review, utilization review, chart auditing... disease management is another option, though i hear the...
  18. dealing with cramps

    a daily dose of dong quai changed my life. it is known in chinese medicine as the woman's ginseng. it has anti-spasmodic and vasodilatory effects. it also has properties similar to both estrogen...
  19. Smelly dog

    i reccomend having the dog sleep under the covers for a nite or two....while youre safely at work. dog will have the proper food no later than lunchtime the 3rd
  20. Arg!!

    tazzi makes a good point, once daddy's little girl, always daddy's little girl... so glad to hear that i am not alone in my struggles with my father....another thing that i get after a lengthy...
  21. I'm concerned for my friend's child....

    your friend is lucky to have you as a friend...and rest assured that you did the right thing for her by allowing her to express her fears... i wonder if some of her teariness is guilt for not noticing...
  22. Disease Management how many are there ?

    i think a lot of merging cm and dm depends on they type of dm company you work for... like i mentioned before, my company is set up so that our "in-house" dm nurses manage the referred condition and...
  23. Disease Management how many are there ?

    wincha, very sweet of you to offer. yes, we do dm for both the aso and fis. however, it's been a challenge locating the dm resources...our resources are split into cm and dm areas. being...
  24. Disease Management how many are there ?

    i work for one of the "large insurance companies." however, i work on the self-insured (aso) side, so it is completely up to the employer group as to whether they opt-in to the disease management...
  25. Disease Management how many are there ?

    sorry renerian....i am a traditional cm....try to get all my members into your dm programs....would be interested in participating however as i have a number of members who either dont have a dm...