Chapter 1 Pretest ... ...... .... .. . . . . .. . . .... . I
Appendix 1-A: Answers to Pretest ... . ... . .. ...... 15
Chapter 2 Case Management Concepts . . . .... .............. ... .. 21
Definition of Case Management .. .. . ..... 21
Philosophy of Case Management ... ........... . 23
Role of the Case Manager .. . . .. . . . ... . .. . . 23
Identiying Patients for Case Management .... . ... .. 27
Accountability ...... 29
References 32
Appendix 2A: Case Management Concept Questions ....... 33
Appendix 2B: Case Management Concept Answers ........ 45
hapter 3 Case Management Principles and Strategies . ........ . 49
Medical Records and Confidentiality . . ..... ..... 49
Medical Records Security .51
Negotiation and Conflict Resolution Strategies . ... . .... 52
Ethical Issues in Case Management .. . . . .. . ... 58
The Case Manager as a Patient Advocate . ... . . .... 62
Informed Consent .....63
Communication Skills 63
interview Techniques 66
Legal Aspects of Case Management .... . . . .. . .. 70
Interstate Compact for Nursing .. 82
References 84
Appendix 3-A: Case Management Princples and
trategies Questions 87
Appendix 3-B: Case Management Principles and
Strategies Answers 127
Chapter 4 Psychosocial and Support Systems . . . . . . . . . . . . 139
Psychosocial and Neurological Assessment .1 . . .. ... . 39
Behavioral Health and Psychiatric Disability Concepts ....... 139
amily Dynamics 140
Multicultural Issues and Health Behavior ... . . .... 142
Psytchologic Aspects of Catastrophic Illness and Chronic Disease . 143
References ..... ........ . 150
Appendix 4-A: Psychosocial and Support System Questions .. ... 151
Appendix 4-B: Psychosocial and Support System AnsweLs , ... 161
Chapter 5 Healthcre Mage et and Delivry . . . .... . 167
Assessing tihe Patienrs . e of Physici an ad Menta Ipaimen .... 167
Orthoses Prostheses an Assistive Devies . ... . .. .... 169
Services and Available Resources .. . . .. . .. . .. 173
Assistive echnology Glossan .. 183
Credentials 185
Referenes .. 188
Appendix 5-A: Healthcare Management and Deivery Qesions .... 189
Appendix 5-B, ea tc re Managemenet and Delivery Answ rs 207
Chapter 6 Healthcare Rei b ursement ........ . . . . ... . 215
Private Benefbit Programn s .. .... .... .. .. . . . . 215
Healthc are Insurance Prin p es .................................. 221
Case Managemrent Ierentions 225
Federal Legislation Important to the Case Manager .. ...... 229
Public Benefit Progra . ... . . .. . . . .. 239
References ... 257
Appendix 6A: Healthcare Reimbursement Questions . ... .... 259
Appendix 6-B: Healthcare Reimbursement Answers ..........33
Chapter 7 Vocational Concepts and Strateges . . . . . .. . . 383
Workers' Compensation Insurance . ... . . ... . . 385
Americans with Disabilities Act of 1990 (ADA) .. ...... .. 387
What Is a Work Hardening Program? .. .389
Life Care Plans . . .. ........................ ................... 391
Appendix 7-A: Votional Concepts and Srategies Quesons ...... 393
Appendix 7-B: Vocational Concepts and Strategies Answer .... 41
Chapter 8 Post- st .. . ... . . . . . . . ... . . 419
Appendix 8-A: Answers to Post-Test . . . . .. .. . 433