Frequently Asked Questions
- 1. How do I pay for Care Management?
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Care management is not covered under Medicare Reimbursement at this time. On average, most families pay privately for services. Care Solutions’ hourly rate for services is $120.
There are a variety of Long Term Care Policies with specific care management services listed or even “nursing visits” which are reimbursed under the policy benefits. Individuals who have a policy should call their policy administrator to review their plan. Our care managers would be happy to help. The highest ranking LTC policies often mention services that can only be provided by members of the National Association of Professional Geriatric Care Managers (NAPGCM). We are current members.
If you have the Secure Horizons Medicare coverage, check with customer service for entitlements under the “Solution for Caregivers” program. This is a program which covers yearly care management services, home safety assessments and assistance with discharge planning and facility identification. Our care managers are credentialed within this insurance group, and we would be happy to help you look at this as a potential payment source.
For those who are still employed, you may have benefits thru your employer. Many companies are now offering assessments for the older adult under their Employee Assistance Programs (EAP). We highly recommend checking into this potential benefit.
Special Needs Trusts are ideal for providing payment for care management. Since these funds are set aside for those things which will enhance the individual’s services and well-being this should always be considered as a good resource. In general, trusts can be of value in providing written instructions for care management services and need to be reviewed for content.
For those who have had settlement awards or are under an insurance plan related to injury or catastrophic events, our RN Certified Case Manager is available to provide care coordination. Our RN is qualified to help in medically complex cases. She would be happy to develop a plan with your designated payor. For those injured in a motor vehicle accident, PIP (Personal Injury Protection) funds may be available to assist with care at your home. Our Certified Care Manager can assist you in reviewing this benefit.
Viatical settlements from Life Insurance policies can be used for care management services. Our care managers can customize any care system needed for end of life care. From simple to complex, we are available.
- 2. How can Care Management help with those who have serious medical conditions?
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Care managers provide coordination of care in all settings. The benefits of having a professional experienced in the medical arena can be enormous. Our RN care manager is aware of the best practice protocols driven by diagnosis. There is better communication between the family and the health care system. Our care managers are there to make sure there is an advocate to provide information and prompt attention to details needed in the care process. Our care managers will review insurance plan coverage and benefits and ensure they are utilized to the fullest extent.
- 3. How does your service work with those on Hospice?
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Our care managers are frequently requested to assist families who are choosing to use their Hospice benefit. We can help families thru the process of initiating services or set up the caregiver system once the benefit is started. All local Hospice providers ask families to identify caregivers and contact individuals if they choose to stay at home. Even if the family is part of the caregiver team, they most likely will need help. For families, it can be very difficult to locate caregivers and direct the care. Our care managers can review the diagnosis, the level of functioning, and coordinate a good caregiver team. We provide all communication logs for home charting; medication management, contact information, and daily progress notes. Our RN care manager will provide caregiver teaching and Nurse Delegation for care tasks. Our care managers will respond to the caregiver calls, family needs or the client’s change of condition. We are aware of the protocols and treatment model and can provide advocacy and prompt communication to the Hospice Team.
- 4. How can you help with those who have a dementia related illness?
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Our care managers have advanced training and working knowledge with those who have cognitive loss. We know the best protocols for treatment and behavior management and can provide direction and resources. Whether your family member is at home, in the hospital, or needs to relocate to a specialty environment, we have the experience with community resources to provide a good outcome for all involved. We are available to facilitate urgent admissions into the specialty Geropsychiatric units in all of the local hospitals.
- 5. How can you help families who have a developmentally disabled adult?
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Our care managers know the community resources needed to provide support for those with developmental disabilities. We are often asked to provide care coordination to ensure individuals are successful with work programs, appropriately relocated to supported living environments, oversee their health concerns, and ensure all legal and financial arrangements are in order. We work with guardianships and Special Need Trusts.
- 6. How can you help with medications: Included Intravenous Home Infusion
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Families often find they have no one to turn to or help with long term medication management.
Our RN care manager is available for regular review of medication management; ensure a good system for administration is provided; and provide professional communication to the client’s medical providers. Many older adults need interpretation and intervention for abnormal blood glucose readings or even blood pressure readings. The care manager will coordinate all of these services. For those who need Intravenous Home Infusion for fluids, antibiotics or specialty protocols, we can assist with the coordination of services; Care Solutions is contracted with specialists who can provide IV insertion at the home.
