Case Management Services
Our overall objective of providing these customized services to clients is to further the mission of hospital-based case management services to provide stand out solutions for case managers, utilization review specialists, and physician advisors living in a revenue cycle framework. The goal of Costa Rose, Inc. is to demonstrate the value of our field as stewards of finance, quality, and patient safety to support a viable healthcare organization. The materials provided with our services align with the mission of Costa Rose, Inc. to support health systems and organizations in transforming their care management divisions to ensure short and long term success and sustainability.
Contact usHow we support
- Ensure case management models and processes meet the standards of practice principles as stated by the American Case Management Association (ACMA).
- Ensure case management models and processes meet the regulatory compliance guidelines as stated by CMS conditions of participation for Discharge Planning §482.43
and/or other third-party payer systems. - Attend on-site consultation assignments of healthcare organizations.
- Apply a QI process to improve operations.
- Provide onsite interim leadership and guidance for contracted hospital case management departments.
- Provide onsite education and training for case management, utilization review, and denials topics.
- Provide off site- remote education services, meeting participation regarding transformation and implementation of case management evaluations.
- Medical record auditing and reporting
and/or other third-party payer systems. - Provide SME support for conference calls and meetings with internal and external stakeholders.
- Recommending alternative transitions of longitudinal care strategies to engage hospital clients and case management professionals in optimization.
Case management services
We participate and contribute input into a program evaluation which includes:
Gathering information
Reviewing documents and data
Interviewing client staff members and physicians
Alignment of care management models with unique population needs promoting supportive, resourceful, trusting relationships between providers, patients and families
Providing guidance for process improvements, workflows and strategic planning
Conducting education programs for physician advisors and hospital associates
Organizing data, generating reports, and compiling reports
Identify Length of stay, bed capacity improvements and denial prevention and management workflow process improvements in healthcare across the entire continuum of cares
Identify and reduce denial write offs, process and quality improvements across the revenue cycle, key performance indicators and operational workflows