Seton Smithville´s Case Management Department serves as a patient advocate by empowering patients and families with information to make informed healthcare choices. The department offers information on important topics, such as Medicare benefits, Advance Directives, Patient Rights and Community Resources.
The case manager is there to help patients in any way. Do not be afraid to share your concerns or needs or to ask questions. It is the case manager´s job to provide information, relieve your worries and try and get you some help. Your physician may want the case manager to evaluate your home situation or to provide you with some information or counseling.
Case managers also are actively involved in discharge planning to ensure patients receive continuity of care and are discharged to a safe environment. Discharge planning meetings occur every morning -- Monday through Friday. Information is collected from all departments involved with the patient, and discharge plans are formulated.
Medicare requires all of its participating facilities to perform utilization reviews of all patients admitted to the hospital. Case managers review every patient´s medical record to ensure those admitted to the hospital meet the criteria for admission. Reviews also include an evaluation of appropriate treatment and use of hospital resources. The Texas Medical Foundation provides guidelines and criteria for hospital admission and discharge screens.
For private insurance patients, case managers are responsible for communicating with the insurance company to obtain authorization for the hospital stay and assisting with any discharge needs.
Case managers are employees of Seton Smithville Regional Hospital and also are available to the surrounding community. Healthcare questions, concerns and issues can be directed to the Case Management Department.