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Outpatient & ED Case Management Programs:

A Necessary Ingredient for APC Success





Length of Program: 120 Minutes


Course Description:


This program is designed to assist facilities with implementation of effective Outpatient and Emergency Department Case Management Programs that will help decrease negative reimbursement impacts of APCs. If you have existing programs or if you are in the design phase of an Outpatient & ED Case Management Program, this course will give the guidance and structure that you must have to survive APC outpatient PPS reimbursement.


Content for the program will include the following:

  • Outpatient & ED Case Management Program

    • Definition, structure, and functions

    • Personnel, staffing levels

    • Reporting structure

  • Required Program Functions

    • UM functions

    • Insurance verification

    • Pre-certification/certification

    • Clinical care management

    • Clinical teaching

    • Discharge planning

    • Communication with next provider of care


Target Audience:

The course is designed for case managers (inpatient, outpatient, and ED), middle managers (including directors of case management, utilization management, emergency room, pre-admission program, business office, admissions/access), and senior managers responsible for these areas of operations (Chief Nursing Officers, Vice-Presidents of Patient Care Services, etc.).



At the conclusion of this program, participants will be able to:

  • Understand the basic structure, functions, and required personnel to maintain an effective Outpatient & ED Case Management Program.

  • Gain an understanding of how to integrate the functions of an Outpatient & ED Case Management Program into other business and care processes.


Register now for our next scheduled course!