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Insurance Glossary

Hospital case management

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Hospital case management is a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet an individual’s health needs, using communication and available resources to promote quality, cost-effective outcomes in the hospital environment.

A hospital case manager coordinates the clinical goals with the patient’s goals and manages the financial and quality outcomes of the care provided. With appropriate training, education and direction, hospital case managers can use their skills to affect a balanced clinical and financial outcome.

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