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Advanced certification is available to Hospital Case Managers through the Accredited Case Manager (ACM) Certification, offered by ACMA. The ACM Certification is the only certification that is specifically designed to validate an individual's competency in hospital case management practice, and is offered to both Nurse and Social Work Case Managers.
Primary Care Case Management (PCCM), is a program of the United States government healthcare service Medicaid.It oversees the United States system of managed care used by state Medicaid agencies in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for ...
The case management restrictions must not "substantially impair access" to primary care services of "adequate quality where medically necessary"; and; The case management restrictions must be "cost effective". [2] In their earliest forms, PCCM programs closely resembled traditional fee-for-service Medicaid than managed care.
Medical case management is a collaborative process that facilitates recommended treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals. It is a role frequently overseen by patient advocates .
The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is a certification body for nursing board certification and the largest certification body for advanced practice registered nurses in the United States, [1] as of 2011 certifying over 75,000 APRNs, including nurse practitioners and clinical nurse specialists.
The member(s) are not required to use a gatekeeper or obtain a referral before seeing a specialist. In that case, the traditional benefits are applicable. If the member uses a gatekeeper, the HMO benefits are applied. However, the beneficiary cost sharing (e.g., co-payment or coinsurance) may be higher for specialist care. [3]
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