reimbursement: case management
The process by which all health-related matters of a case are managed by a physician or nurse or designated health professional. Physician case managers provide coordination for designated components of the health care, such as appropriate referral to consultants, specialists, hospitals, ancillary providers and services. Case management is intended to ensure continuity of services and accessibility in order to overcome the systems rigidity of many health care systems, fragmented services, misutilization of facilities and resources. It also attempts to match the appropriate intensity of services with the patient's needs over time.*
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*Extracted from Family Physicians and Managed Care: A View to the 90's: (paperback 1993) with permission from American Academy of Family Physicians