Forest Hills Hospital has integrated Utilization Management, Appeals Management and Social Services under one umbrella to form the Case Management Department. This department consists of social workers, nurse case managers, a physician advisor and support staff that work collaboratively to formulate and facilitate timely, safe and effective discharge plans for our patients. The nurse case managers provide clinical and psychosocial assessments and conduct reviews of all inpatient cases using established guidelines. They provide clinical updates to insurance carriers, and also collaborate with the physicians and staff nurses regarding patient care, assisting them with expediting care and discharge plans.

The social workers work with the patients and their families to address psychosocial issues that may affect the patients' overall health status and collaborate with the case managers and the interdisciplinary team on the discharge plans. They provide information and education on community resources, make referrals when necessary and give counseling and supportive services to patients and families in crisis.

The appeals management team reviews and appeals all third party payor denials concurrently as well as retrospectively and assists the patients, families and physicians throughout the denial process.

The Case Management staff visits patients at bedside to present them with discharge information. Family members can also visit the office on the 8th floor to request information. Resources that are available include details on discharge options, list of private hire agencies, care centers and nursing homes, assisted living facilities, adult homes and home care agencies. There is also information on elder care attorneys, transportation options and applying for Medicaid. The department has videotapes and brochures that make it easier for patients to choose post-discharge providers.

Case Management also interfaces with other departments as a clinical resource. The department works with the Community Outreach Team in facilitating support groups and in building good community and business relationships that provide benefits for our patients.

Hours of Operation

Monday to Saturday
8 a.m. to 5 p.m.

Location

Forest Hills Hospital, 8th Floor
Forest Hills, NY 11375
(718) 830-4161/4140