The ______________ represents the bill payer and certifies that the care to be rendered is both effective and the least costly alternative.

Question

Quizplus · Accepted Answer

The role of a case manager is to ensure that healthcare is provided efficiently and cost-effectively while also promoting positive outcomes for the patient. In this scenario, the case manager would represent the bill payer (usually an insurance company) and work to ensure that the care being provided is both effective and cost-efficient. Social workers may assist with the coordination of care, but they typically don't have the same level of authority and decision-making power as a case manager. HMOs and hospital administrators may be involved in the provision of care, but they don't necessarily represent the bill payer in this context.

The ______________ Represents the Bill Payer and Certifies That the Care