Encouraging Clerical Support for Case Managers
August 1, 2023
By Jeni Miller
Case managers perform a varied and full load of tasks each day, but is each one equally worthy of their time?
It is becoming more valuable for case managers to consider requesting clerical staff to assist with tasks that do not require the skills of an RN or social worker. Toni Cesta, PhD, RN, FAAN, partner and consultant with Case Management Concepts, shares a few best practices and considerations for those who would like to evaluate how to delegate tasks that are not the best use of case manager time. These best practices also can be used as a blueprint to develop this role.
“A case management clerical support staff would ideally be comprised of non-licensed professional staff that is specially trained in this role and hand-selected to support the needs of the case management department,” Cesta explains.
This staff member could carry a caseload of up to eight RNs or social workers and would be assigned directly to those professionals. It could be part time or full time, depending on the caseload and support needs of the department. In either scenario, this frees the case managers to focus on tasks that are most urgent and require their expertise.
Cesta, whose clients have opted for clerical support staff in the past, says that it is a “dreamy” arrangement. “When hospital leadership sees and understands how to set up this support staff, and when the department is staffed correctly in general, it’s so much more likely to be successful,” she notes.
Clerical support staff can assist with discharge planning in many ways. This important function could use all the support it can get to prevent any details from slipping through the cracks. Clerical staff helping maintain accurate lists of post-acute care settings and their availability is a significant time-saver for case managers. According to Cesta, the list might include skilled nursing facilities, infusion services, hospice, durable medical equipment, home care agencies, long-term acute care facilities, and acute rehab facilities.
Phone calls, emails, faxes, and other communication can fall to this support role as clerical staff can take over communication with different facilities regarding bed availability, using the case management electronic discharge system as needed. This role also is useful for creating transfer packets to skilled nursing facilities, rehabs, and long-term care hospitals, and ensuring all transfer documentation is complete.
Staff also can devote time to ensuring excellent communication with families during the discharge and transfer processes. They can help arrange transportation and ensure families receive all the information they need before the transfer. Clerical staff also can arrange for durable medical equipment for the patient’s home.
Clerical staff can proactively manage other duties relating to discharge planning and transfers, or other helpful tasks that serve families and patients, like making follow-up appointments.
Clerical staff in case management can support the utilization management role by obtaining authorizations from commercial insurance companies for transportation, durable medical equipment, home care or skilled nursing facilities, and medications. They also can help with sending insurance reviews to third-party payors, as needed.
Assistance with compliance tasks — which often are moved to the back burner — can free a case manager’s time considerably and ensure the department and hospital are meeting compliance standards, Cesta notes. Clerical staff can deliver Medicare observation letters, obtain choice selections from patients and families, and provide patients and families with other communication as directed by case management.
All these tasks help provide space for case managers to focus on the highest priority functions that require their professional skills, Cesta says. Ensuring they can make the most of their role significantly affects the bottom line, as too many hospitals are losing money in denials and seeing lengths of stays that are far too long, often worsened when case managers are spread too thin and cannot focus on their primary tasks.
Case managers perform a varied and full load of tasks each day, but is each one equally worthy of their time? It is becoming more valuable for case managers to consider requesting clerical staff to assist with tasks that do not require the skills of an RN or social worker.
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