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Author : Anonim
Publisher : Unknown
Page : 46 pages
File Size : 43,9 Mb
Release : 2000
Category : United States
ISBN : UOM:39015050498248
Author : Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN,Rebecca Perez, MSN, RN, CCM, FCM,Corine Latour, PhD, RN
Publisher : Springer Publishing Company
Page : 316 pages
File Size : 42,9 Mb
Release : 2018-01-28
Category : Medical
ISBN : 9780826169518
Written by case managers for case managers, this reference manual for nurses and other health professionals presents a CMSA tested approach towards systematically integrating physical and mental health case management principles and assessment tools. Since the health care field has undergone major changes such as the passing of the Patient Protection and Affordable Care Act, Mental Health Parity, Transition of Care & Chronic Care Management and the Medicare Act and CHIP Authorization Act (MACRA), health care workers must competently know how to integrate those new regulations, describe alternative payment options, and implement requirements for greater patient and family assessment, care planning, and care coordination in their practice. CMSA’s Integrated Case Management delves into the role of the case manager and unpacks how case managers assess and treat complex patients. These are patients who may be challenged with medical and behavioral conditions, poor access to care services, as well as chronic illnesses and disabilities, and require multidisciplinary care to regain health and function. With a wealth of information on regulatory requirements, new models of care, integration of services, digital and telemedicine, and new performance measures that are clearly defined for nurses in nursing terminology, chapters outline the steps needed to begin, implement, and use the interventions of the Integrated Case Management approach. All content aligns with the newly revised 2017 Model Care Act, CMSA Standards of Practice 2016 as well as the CMSA Core Curriculum for Case Management Third Edition.
Author : Gary L. Wickert
Publisher : Juris Publishing, Inc.
Page : 1616 pages
File Size : 40,7 Mb
Release : 2012-04-01
Category : Law
ISBN : 9781578233632
Workers' compensation subrogation continues to change and adapt, as trial lawyers prod its weak points and capitalize on confusing areas of the law. There have been numerous changes in workers' compensation statutes and case law in many states since the last edition. This edition includes an exhausting survey and detailed explanation of the crazy status of employer contribution in Illinois, which includes a step-by-step exposition of how contractual indemnity and the "Kotecki cap" play a role in expanded employer liability in Illinois workers' compensation subrogation cases. It covers the many nuances of Naig and Reverse-Naig settlements under Minnesota law, including an analysis of who has what burdens of proof and the effect such a settlement has on the remaining third-party case tried to a jury. In light of the landmark Missouri Court of Appeals decision in Robinson v. Hooker, the liability of co-employees in Missouri and surrounding states have been covered in greater detail. The concept of co-employee liability for acts which are intentional or committed outside of the course and scope of employment has been added in several states. New case law and explanations were added to the Texas chapter with regard to subrogating against UM/UIM policies, including arguments with regard to the efficacy of UM/UIM exclusionary policy language and the ability to subrogate against a UM/UIM policy actually issued by the same carrier insuring for workers' compensation coverage. West Virginia completely revised their subrogation statute and created a new statute relating to the "statutory employer" status of primary contractors and subcontractors on construction sites, limiting when and how primary contractors can become legitimate third parties for purposes of subrogation. Chapter 7, "Contractual Limitations to Subrogation" has been completely overhauled to include new statutes and case law for every state to assist practitioners in determining the law applicable when there is an alleged applicable waiver of subrogation which might otherwise destroy subrogation. A new Chapter 12 has been added, which focuses on jurisdiction of workers' compensation third-party actions taking a broad look at 28 U.S.C. § 1441, which prohibits removal of cases "arising under" state workers' compensation laws. A carrier now has the ability to prevent cases from being removed from favorable venues in state court to less favorable federal court venues - an attractive option for plaintiffs' attorneys with whom subrogated carriers can negotiate with for stipulations and concessions on their subrogation interests in exchange for maintaining a case in state court. This edition also expands on which states do and do not hold workers' compensation to be primary. Combined with more than 100 new case decisions, this Fifth Edition is the most complete and up-to-date edition yet. Workers' Compensation Subrogation is the most complete and thorough treatise covering workers' compensation subrogation ever published. There are very few areas in which the laws of each state vary more and are applied as differently, then in the area of workers' compensation subrogation. This book is intended to introduce the workers' compensation claims handler, in-house counsel, and subrogation professionals to some of the more esoteric and complex subrogation issues encountered in today's workers' compensation insurance subrogation marketplace. It covers the following issues in all 50 states: • Allocating Third Party Recoveries • Attorney's Fees • Borrowed Servant Doctrine • Conversion of Workers' Compensation Liens • Costs and Expenses • Dual Capacity Doctrine • Equitable Subrogation/Contribution • Exclusivity Rule Barring Action Against Employer • How To Calculate Your Credit/Advance and How It Is Applied In Each State • Intentional Acts • Joint Ventures • Made Whole Doctrine As Applied To Workers' Compensation Subrogation • Necessity of Intervention • Lien Reduction Statutes • Staff Leasing Services and Temporary Employment Agencies • Statutory Subrogation Rights • Subrogating Against UM/UIM Benefits • Subrogating In Medical Malpractice Cases • Subrogating In Legal Malpractice Cases • Waivers of Subrogation • Who Qualifies As A Third Party • Other Workers' Compensation Subrogation-Related Issues In addition to being an excellent primer on workers' compensation subrogation, suitable for both the new subrogation professional and the seasoned veteran, the book also contains a detailed synopsis of the workers' compensation subrogation laws in each of the 50 states. It is a must for anyone with multi-state subrogation responsibilities. Complete with diagrams, references and thousands of footnotes, this is the most ambitious workers' compensation subrogation project ever undertaken. The following issues and topics are covered in detail for each of the 50 states: Statutory Subrogation Rights • Identifies the statutory authority for workers' compensation subrogation in that state. • Discusses the purpose/legislative intent of the statute. • Is an election necessary by the worker? • Who can bring a third party action (plaintiff, carrier, employer, or all of the above)? • When and must a third party action be brought? • What are the rights of a carrier to intervene in an existing third party action filed by a worker? • Will a worker's compensation carrier's subrogation interest be barred if not brought timely? Third Parties • Who can be sued as third parties in a third party action? • Can a co-employee be sued and under what circumstances? • Can an uninsured/underinsured carrier be a "third party" under the laws of that state? • Is there a dual capacity or borrowed servant doctrine which somehow affects the ability of a worker's compensation carrier to effectively subrogate? • What is the state's workers' compensation bar? • Are there any specific restrictions regarding subrogation against a subcontractor or an employee of a subcontractor in a construction situation? • Under what circumstances can the employer be sued? • Can a carrier subrogate to the benefits of a recovery in a legal or medical malpractice action? Allocation of Third Party Recovery • How and when does the carrier recover its subrogated interest? • Does the carrier recover past benefits only or also the present value of future benefits which it owes under the Workers' Compensation Act of that state? • Is there a formula used to determine how a third party recovery is allocated? • What happens to the total recovery and how is it applied? • Can a carrier recover benefits paid by a third party or recovered in a third party action which relate to loss of consortium, or non-economic damages such as pain and suffering, mental anguish, or punitive damages? • Does the employer's negligence reduce the recovery by the worker or carrier? Attorneys' Fees/Costs • Can the plaintiff's attorney recover attorneys' fees and/or costs out of the carrier's subrogated recovery and under what circumstances? • How are attorneys' fees and costs handled if the carrier is also represented by subrogation counsel, intervenes into the third party action and actively represents its interest? • What if the carrier isn't represented? • Can a plaintiff's attorney recover attorneys' fees based on the value of past benefits only or will he be able to recover attorneys' fees based on the future benefits/credit recovered by the carrier? • Must a carrier bear its proportionate share of expenses as many states require, and what does that really mean? Credit/Advance • Can a carrier take a vacation from paying workers' compensation benefits once a worker makes a third party recovery? • How is the credit calculated under state law? • Does the carrier have to do anything special to obtain the credit, such as filing with the Workers' Compensation Commission? • Does the carrier get a credit toward future compensation benefits it owes or does it actually get to collect the present value of the future benefits it owes and still be obligated to pay the scheduled benefits in the future? Statutes of Limitation • What are the applicable statutes of limitation or statutes of repose that may be applicable to third party subrogation actions? Related Subrogation Issues • Are there any other issues or statutes which affect a worker's compensation carrier's right of subrogation, such as the made whole doctrine, common fund doctrine, or anti-subrogation statutes? • Are there any lien reduction statutes, such as those existing in Indiana, which affect a worker's compensation carrier's right of recovery? • Does the state have any no-fault laws which complicate workers' compensation subrogation involving an automobile accident, such as exist in Michigan and Colorado? • What are the carrier's options if the worker and his attorney simply refuse to repay a worker's compensation carrier's lien after settling a third party action? • If the worker fails to repay the carrier, is there a cause of action for conversion of a carrier's subrogation interest or may the carrier still proceed against the third party tortfeasor to recover its subrogation interest?
Author : Dorothy Consonery-Fairnot
Publisher : Unknown
Page : 264 pages
File Size : 48,6 Mb
Release : 2012-08-21
Category : Vocational rehabilitation
ISBN : 1610052145
Author : Matt Kruger,Chris E. Stout,Jeff Rogers
Publisher : Bentham Science Publishers
Page : 278 pages
File Size : 53,6 Mb
Release : 2011-04-23
Category : Medical
ISBN : 9781608052516
This e-book integrates all aspects of medical care relevant to worker compensation. It explains benefits of the application of evidence-based approaches to worker compensation care. Improved outcomes of such approaches include less risky treatments, faster healing, and good return to work experience. It also points towards designing a better health care system with a focus on the economy, healthcare policy and change, and growing innovation in medical practice. The e-book should serve as a significantly important reference tool for several working professionals in healthcare systems as well for as students and trainees.
Author : Catherine M. Mullahy
Publisher : Jones & Bartlett Learning
Page : 896 pages
File Size : 45,7 Mb
Release : 2010-10-25
Category : Medical
ISBN : 9780763777241
Written by renowned author Catherine Mullahy, The Case Manager's Handbook, Fourth Edition is the ultimate how-to guide for Case Managers. It is designed to define good case management, examine the case management process, and present practical procedural information. The Fourth Edition has been completely revised and updated with new references and pertinent information. This book is an excellent daily reference or can be used as a training guide for new case managers, or a teaching tool for client groups. Accompanied by a CD-ROM and a FREE Student Study Guide is available online.
Author : Christopher Ball
Publisher : Nolo
Page : 457 pages
File Size : 41,7 Mb
Release : 2016-05-08
Category : Law
ISBN : 9781413322705
More than a million Californians a year suffer job-related injuries or illness. For many, receiving compensation can be a nightmare, since recent laws give employers and insurance companies far greater rights and employees fewer medical benefits. California Workers' Comp shows how to handle a California workers' compensation claim from start to finish. This plain-English guide, explains how to work with the insurance company to receive the medical treatment and benefits. Workers will find out how to: file a claim protect their legal rights receive the medical care they need get the benefits they're entitled to deal with uncooperative employers, doctors, and insurance agencies negotiate a settlement present their case before a judge This complete guide can help people handling their own claims or filing on a minor or other's behalf. This edition is completely updated to cover significant changes in the area of permanent disability ratings, along with recent updates to the Labor Code and other workers' comp laws. A comprehensive chapter is included for computer users with repetitive strain injuries.
Author : Rhoda Neader RN, CHPN, CCM
Publisher : Outskirts Press
Page : 89 pages
File Size : 52,6 Mb
Release : 2018-12-13
Category : Medical
ISBN : 9781977207616
End of life care has made vast improvements. However, statistics show that aggressive high cost care for patients continues to be widespread. Costs in end stage medicine continue to be extensive and sometimes physically, emotionally or financially exhausting for patients and their families. We find that this doesn't always necessarily offer the patient quality of life care or address the patient's actual wishes until too late. We continue to see very Ill patients in and out of the hospital or rehab units for their final weeks to months of life. We continue to struggle to identify the patient's wishes and goals until they are hospitalized or in crisis despite many advances in establishing advanced directives. In the old saying "We know more about our refrigerators than about our health insurance," many individuals do not understand their insurance and may feel quite overwhelmed by this complicated process. Rhoda Neader's book "Case Management: A Palliative Perspective" includes basic insurance resources for anyone interested in learning more. It is a must read tool for case managers, nurses or anyone wishing to know more about the insurance maze. It offers a well more comprehensive approach for anyone in their patients or their family’s end of life experience.
Author : Charles A. Warnes
Publisher : Lrp Publications
Page : 54 pages
File Size : 50,6 Mb
Release : 1992
Category : Business & Economics
ISBN : 0934753652
Author : Patricia W. Iyer, MSN, RN, LNCC
Publisher : CRC Press
Page : 1168 pages
File Size : 55,7 Mb
Release : 2002-11-26
Category : Law
ISBN : 0849314186
Designed to meet the needs of both novice and advanced practitioners, the first edition of Legal Nurse Consulting: Principles and Practice established standards and defined the core curriculum of legal nurse consulting. It also guided the development of the certification examination administered by the American Legal Nurse Consultant Certification Board. The extensive revisions and additions in Legal Nurse Consulting: Principles and Practices, Second Edition make this bestselling reference even more indispensable. The most significant change is the inclusion of 15 new chapters, each of which highlights an important aspect of legal nurse consulting practice: Entry into the Specialty Certification Nursing Theory: Applications to Legal Nurse Consulting Elements of Triage for Medical Malpractice Evaluating Nursing Home Cases Principles of Evaluating Personal Injury Cases Common Mechanisms of Injury in Personal Injury Cases ERISA and HMO Litigation The LNC as Case Manager Report Preparation Locating and Working with Expert Witnesses The Role of the LNC in Preparation of Technical Demonstrative Evidence Marketing Growing a Business Business Ethics Legal Nurse Consulting: Principles and Practices, Second Edition presents up-to-date, practical information on consulting in a variety of practice environments and legal areas. Whether you are an in-house LNC or you work independently, this book is your definitive guide to legal nurse consulting.
Author : John D. Rasch
Publisher : Charles C Thomas Pub Limited
Page : 213 pages
File Size : 45,6 Mb
Release : 1985-01-01
Category : Social Science
ISBN : 0398050872
Author : Gustavo Ortiz,Sean Nitzen
Publisher : Lulu.com
Page : 82 pages
File Size : 47,5 Mb
Release : 2006-11-01
Category : Business & Economics
ISBN : 9781430309567
8 Steps to a Winning Workers Comp Program is a simple grass roots risk management method used to help small to medium sized employers control their losses, contain claims costs and save on insurance premiums. It centers around consistent communication and promoting the employers involvement in all aspects of their risk management and claims activities
Author : Suzanne K. Powell
Publisher : Lippincott Williams & Wilkins
Page : 548 pages
File Size : 45,9 Mb
Release : 2000
Category : Medical
ISBN : 078171883X
The Second Edition of this comprehensive "how to" text has been completely revised and updated. This text outlines the basics of case management and illustrates some of the pitfalls encountered in the field of case management. The book provides information on the new Case Management Standards, supplies standard definitions and guidelines of case management for the practicing case manager, and presents information on caring for clients in a wide variety of health care settings. New to this edition--chapters focusing on Quality Reviews and Risk Management with a strong emphasis on Continuous Quality Improvement (CQI), ethical and legal issues, and various case studies.
Author : Jack W. Plunkett
Publisher : Plunkett Research, Ltd.
Page : 485 pages
File Size : 42,8 Mb
Release : 2007-11
Category : Electronic
ISBN : 9781593920975
Insurance and risk management make up an immense, complex global industry, one which is constantly changing. Competition continues to heat up, as mergers and acquisitions create financial services mega-firms. As the insurance industry grows more global, underwriters see huge potential in China, the world's fastest-growing business market. Meanwhile, technology is making back-office tasks easier and more efficient, while direct selling and e-commerce are changing the shape of the insurance industry. This carefully-researched book (which includes a database of leading companies on CD-ROM) is a complete insurance market research and business intelligence tool-- everything you need to know about the business of insurance and risk management. The book includes our analysis of insurance and risk management industry trends, dozens of statistical tables, an industry glossary, a database of industry associations and professional organizations, and our in-depth profiles of more than 300 of the world's leading insurance companies, both in the U.S. and abroad.
Author : Jack W. Plunkett
Publisher : Plunkett Research, Ltd.
Page : 487 pages
File Size : 44,7 Mb
Release : 2008-11
Category : Business & Economics
ISBN : 9781593921330
Everything you need to know about the business of insurance and risk management--a powerful tool for market research, strategic planning, competetive intelligence or employment searches. Contains trends, statistical tables and an industry glossary. Also provides profiles of more than 300 of the world's leading insurance companies--includes addresses, phone numbers, and executive names.