The plan takes into account the patient's medical condition, psychological status, and social support, as well as expectations about what is realistic and feasible given the constraints of a patient's situation. The plan includes physical and psychological aspects of care, coordination of service delivery and resources, and community re-entry interventions. At the same time it takes into consideration the requirements of the patient's insurer and reimbursement criteria. Information about coverage and benefits must be included when developing the plan to ensure that patients are getting the most out of their insurance plan and that enough resources exist to carry out the plan. Case management plans should contain specific actions, including their steps, sequence, duration, and frequency.
Many case managers specialize in a particular area and are quite knowledgeable.
They rely on their expertise and experience to plan for each patient's unique characteristics and situation. Developing a plan that is agreeable to all parties requires skills in communication, negotiation, and collaboration. Case managers check with providers to be sure certain services are available. They check with payers to ensure services are covered and follow required guidelines for authorization. They also check with the family members who are expected to take an active role in providing care.