gonzoRN

Deanna Gillingham's book CCM Made Easy is the gold standard. Her website is also a great resource. Good luck!

I spent almost 6 years as an insurance UM nurse doing inpatient UM, and last year, transitioned to hospital UR. It wasn't difficult, however, it definitely took some adjustment. Specifically, the physician/RN relationship. On the payer side, it was a MUCH more collaborative and respectful relationship. On the hospital side, it's pretty confrontational, particularly as it applies to observation vs inpatient. That may be a function of the culture at the hospital I work in, but it is definitely a down side, the lack of respect for UR nurses.

Relocating, for me, was a complete disaster, and extended my time significantly. Before you pack up that moving van, be crystal clear on your contract. After 2 years in a monitoring program, I moved to Florida. Rather than finishing out my original 5 year contract, IPN gave me a new 5 year contract, putting me at a total of 7 years in monitoring. It sucked, to say the least. My parents needed me there, so I really didn't have a choice in the matter. That was a longgggg 7 years, let me tell you.

From my point of view, not interested in separate labs/imaging. If the results are included in H&P, progress notes, then it's redundant to send the extra. However, we don't generally accept your review--it's actual progress notes/H&P. If you have to send review, then we prefer MCG/Interqual review with actual notes cut and pasted in.

See below...

The insurance company, contrary to belief, is not your enemy. Find out who the health plan case managers are for your facility/unit/what-have-you and say Hi. I have relationships with acute hospital CMs/discharge planners all over the country, and they are always amazed.....YOU are here to HELP me??? Yep. We want to move the discharge plan along too, and any help I can give, within my scope, I'm there. I arrange transportation, call the medical director, get the approval, organize the doc to doc, etc. and get back to you. Let them help you, and don't come at them with the "insurance company is the devil" attitude, and you'll be amazed at the result. Good luck in your new role--I love case management, and hope you will too!

I work 5-8s. My husband is/was the cook in our house. He loves it, I was always "meh", and never felt very imaginative. He went back to school full time, and I decided that I needed to pick up more of the cooking duties. I heard about these services, and decided to jump in. First, we tried Blue Apron. It was a great choice to get started. I liked 80% of the meals, I learned new stuff/techniques and tried new things. We had rotten corn one week and they comped us the entire week. So, yay! The main thing I didn't like was the selection of meals. Pretty thin compared to the other services, like others have said. I decided to go with HelloFresh, and have been much happier. You have a much better choice of meals, and so far, I've loved all the meals I've done. I prefer the way HelloFresh packages their ingredients--everything for a meal in one box for example. With Blue Apron, they put some of the things in a little paper bag, vinegars etc would leak, and the paper bag would disintegrate from a) the leakage and b) the ice packs. So there's that. I would love to try Marley Spoon and PeachDish, but Marley Spoon hasn't come to my area yet, and PeachDish charges 15$ shipping for my area. So, I'll keep doing what I'm doing. Bottom line, this little project has gotten me excited about cooking again. I'm making stuff that I never would have even thought of, which is fun. I've learned some new techniques along the way, which is cool. And the husband is thrilled that he's getting cooked for, not the other way around.

I moved twice while on contract. Once to get away from a toxic marriage, and the other time to get home to care for a parent undergoing treatment for cancer. Both times, I had to physically go before the Board and petition for my license, and the right to enter their monitoring program. The first state accepted my "time served" from the state of the initial discipline. FL did not. I was required to do the full 5 years on top of the three years I had already completed. So, yes, I was monitored for a total of EIGHT years. Documentation was key. I had to produce the actual contracts from both states, documentation from the inpatient rehab I attended, statements from the prior states programs detailing my progress through their program, letters of recommendation. Tips: start gathering your documentation from the beginning of your time in monitoring, have at least 6 months of savings (I was single, and it took 6 months to get the FL license), be mentally prepared for the shame of begging for a license from a room full of complete strangers, and think long and hard about whether or not a move will be worth all of the above. Would I do it again? Doubtful. Most stressful 8 years of my life, hands down. I felt like I had won the lottery when I finally completed IPN.

I took the exam in December and passed. I had read in multiple places that the new blueprint for the exam was going live in August and that results wouldn't be given right away. Sorry you guys had to wait! For those taking upcoming CCM exams, I used CCM Certification Made Easy which is now in it's second edition for the new blueprint. This book was fantastic...I used it, the workbook that goes with it, Quizlet decks, and took the CCMC practice test about a month before I took the test to focus my studying.

Not the whole process--just monitoring, mandatory group, and ... time.

This is a great point. Have you looked into any of your regional health systems--many have their own insurance companies these days. The particular one I work for is actually more popular in my state than any of the National companies. The application process wasn't that arduous, but to be fair, my situation was a "who you know" kind of thing. Good luck!

My last move was FL and into IPN. The move was necessary, to take care of a parent with cancer. The hardest part, believe it or not, was physically appearing before the BON. It was the most demeaning thing....standing there asking/begging to keep my license and to have the "privilege" of another 4 years of monitoring. I tried to look at the whole thing as character building, but it was hard. Fortunately, my parent did well, we both made it through, and they are still with me today!

This. And you're not alone. I always say, I'm an introvert who plays an extrovert in real life. I was in CVICU for a longgg time, and the nightshift was a godsend. Our unit was designed in such a way as to make congregating together rather difficult. I pretty much hung out in/around my room(s). I've also had to be extroverted as a DON, which was HARD. "Smile and nod" is hard for me. I'd get "what's wrong" all the time, when all I was doing was thinking. Guess I have the resting BF, LOL. These days, I work from home for an insurance company, and could not be happier. I appreciate the quiet, and the ability to focus without a bunch of distractions.

My two cents. I moved twice during monitoring. Complete pain in the rear, but it can be done. However, both states made me start over. I completed over EIGHT years of monitoring. Since finishing, I've moved twice. Neither of those states required me to go back in to monitoring, although the hoop jumping I had to do was insane. My background...I self reported, alcohol, never arrested. I highly encourage everyone to keep every scrap of documentation, in paper and in the cloud. If you ever plan on moving start working on your letter now. Every board and every potential employer will ask for that explanatory letter. Get help with it from your sponsor, your support group, your attorney. I can't stress enough how important that letter is. Lastly, move to a compact state, opens your options up dramatically.

The Albuquerque SNF market is pretty desperate for nurses, I personally know of more than a few buildings that have been using agency for a while now. PM me, Ill give you more info.