Case Management

What is Case Management?

It is a process, managed by your healthcare team, to help you and your family find medical solutions. The case manager is your team coach and advocate. Together, you develop a plan of care to promptly control your illness, injury, or situation, and navigate through the maze of medical care progressing toward your medical goal.

Due to Case Manager understaffing and Navy mandates, Case Management is open to Active Duty Service members and primarily those in a Limited Duty status. Case Management is also open to a limited extent, to patients with a complex, life threatening diagnosis.

A goal of the limited duty process is to expedite the return of eligible service members to a "return to duty" or "fit for duty" status. We need to return our trained and skilled personnel to productive service in the shortest time possible.

Who is eligible?

• Active Duty Service Members
• On a limited basis, non-active duty MTF enrolled patients

*If you are ineligible for MTF Case Management services, you may be referred for care with the Health Net Federal Services Case Management team.

Non LIMDU Diagnostic Categories considered: Diagnostic categories

• Catastrophic illness or injury
• Serious terminal illness

Who are Case Managers?

Case managers are usually nurses or social workers who can help you and your family figure out complex health care and support systems. They will work with you to coordinate the services and other community resources you need.

They can help:

• Provide advocacy, support, and education
• Reduce burden and streamline appropriate utilization of care
• Partner with members of your healthcare team to assist in coordination of your healthcare needs
• Monitoring for progress and desired outcomes

Why would I need Case Management?

The need for case management services is determined through a collaboration between you, your family or caregiver, your health care team, and your provider. This collaboration will include a comprehensive assessment of your health, psychosocial needs, and use of health care services and resources.

Case Management can help by:

• Coordinating your care
• Assessing, planning, and facilitating services for you
• Evaluating your options
• Advocating on your behalf

Who will be my Case Manager?

You will work with a registered nurse and/or social worker. Everyone has the same goal — to help you reach optimum health as soon as possible.

Will my Primary Care Manager be informed of these plans and services?

Your PCM is part of the team that helps you make plans and decisions about your health goals. Based on these goals, your case manager develops a plan and continually updates it as you progress.

Along the way, we share with you:

• Your progression according to the case management plan
• Our professional evaluation of your response to treatment
• Medical insurance coverage as it impacts identified medical needs

Your Rights:

• Privacy
• Be cared for with courtesy and respect
• Be told about your health care problems
• Be told how your problems are usually treated and share in the planning
• Be told what you can expect from treatment
• Be counseled about what complications could occur if you refuse a treatment

Your Responsibilities:

• Treat the case manager with courtesy and respect
• Ask questions about any part of the care you do not understand
• Discuss with the case manager any changes in your condition or how you feel
• Talk to the case manager about other health problems you have had in the past
• Inform the case manager about all medications and remedies you are using
• Follow through on shared goals
• Let the case manager know if you are having problems following any instructions
• Let the case manager know if you decide not to follow the plan of care