Case Managers Get You Connected

Written by Tonya Cochran, RN, BSN, RDCS, CES and Lindy Rodgers, RN
Reviewed by Kenneth Hackney, MD

Case Management is all about teamwork and customer service. The Commission for Case Manager Certification defines Case Management as a “collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client’s health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes.”¹    

So how does this apply to College Health?

As part of nursing services, the Case Management office is available to assist students to navigate their health care needs at the Student Health Center or in the local community. The goal at Student Health Services is to provide students with quality care and provide best outcomes to achieve the maximum potential in academic careers.

“We want to thank [Case Management] for going above and beyond to help our daughter get the medical attention she needed. The kindness and care [Case Management] gave put her at ease and meant the world to us!” – Mother of TAMU Student

Last year, Case Management coordinated over 3,300 patient referrals to medical specialists, emergency rooms, labs, and radiology services in the community. This number is equivalent to 6.3% of the over 53,000 student clinic visits last year. For continuity of care, case managers serve as liaisons to obtain the medical records and assist with follow up care, if needed. The expediency of follow through has been key to many patients with significant findings requiring extensive treatment and successful outcomes.
As part of the collaborative process, Case Management staff are ready to assist new students entering the University who have existing medical conditions or special requests. Staff are able to assess, assist, and implement plans to prepare the student for an easier transition to start a new college experience. Case Managers are well networked and as resource managers, they are able to provide guidance and contact information on campus or within the community. Examples often include educating patients of other ancillary services available on campus. Some collaborative partners include: Disability Services, Student Assistance Services, Residence Life, Student Legal Services, International Student Services, and Veteran Services. Case Management staff can also assist with establishing care with Student Health Services medical staff as well as community specialists.
Understanding an insurance plan and how to navigate the system can be very cost effective for the patient when considering out of pocket expense. The case manager frequently educates the patient about basic concepts of the plan and defines terminology that can often be confusing. Patient education often helps the patient evaluate the options available and assists in making educated decisions. 

Multiple providers off campus are available for most PPO plan networks in this area. The Customer Service number on the insurance card is useful to confirm.

For HMO plans, the PCP will need to be changed to a local physician (if one is available) or another insurance considered unless a trip home is reasonable. A&M offers a modestly priced Blue Cross Blue Shield (BCBS) PPO plan for several weeks into each semester for consideration. Contact SHS Patient Services for more information: (979) 458-8310.

Student Health Services contracts with a telephone nursing service that is available to students 24/7 to answer questions or concerns. The case manager can monitor and assess Dial-A-Nurse calls. When noted, the case manager will contact the patient to check on the status and will assist with scheduling an appointment or provide and implement a plan of care.

Reference:

  1. Case Management Knowledge. (2017). Retrieved June 26, 2017, from https://www.cmbodyofknowledge.com/content/case-management-knowledge-2.
By | 2017-11-10T08:04:27+00:00 July 1st, 2017|Case Management, Health, Health Clinic, Nursing|0 Comments