Question

Unit 4 Discussion Discussion Topic Roles To ensure appropriate resource coordination, what roles should be performed by case management or utilization review staff? How do these roles allow for better communication with different departments? Share your perspective and justify your position.

Answer 1

Roles of Case Management and Utilization Review Staff

The case management staff acts as a catalyst for the group since its different care providers, who have a place with a variety of disciplines, should be activated for a common reason. The case manager is both the eyes and the ears of the patient, his guardians, and his friends and family. All things considered, it is a significant wellspring of data for all. The case management staff respects the patient, builds up an association with him, assembles necessary data from him and his family, evaluates his physical condition, recognizes his bolster system, envisions care prerequisites, makes arrangements for the fundamental methodology and starts them(cmbodyofknowledge, n.d.).

The utilization review staff investigates persistent records to decide the authenticity of confirmation, treatment, and length of stay in the human services office to consent to government and insurance agency repayment strategies. It analyses protection, legislative, and certifying office benchmarks to decide criteria concerning affirmations, treatment, and length of stay of patients. It is in charge of contrasting inpatient restorative records with built up to standards and meets with medicinal and nursing workforce and other expert staff to decide the authenticity of treatment and length of stay(health, 2006).

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