UAE CMCT01 E-learning _ Insurance

CLAIMSCASEMANAGEMENTAPPROACH

Case managers readily look for opportunities to receive feedback as a mechanism to refine their practice. This feedback is specific, with examples of what they did (or did not), do or say, and how it impacted on the situation. They use the opportunity to reflect on what they could have done differently and apply the learnings immediately. They put structures in place to help embed these new practices, to ensure they are sustained. Case managers provide feedback with specificity – describing the situation, what the other person did (or did not) and the impact of this, on the outcome. When providing constructive feedback. They take a collaborative approach to identifying alternative actions or in the case of a provider, specify what they would have preferred as an alternative action.

Case managers recognise the need for termination planning for all claim closures. They consider when to commence termination plans on a case by case basis – understanding that some cases may require more planning and supports than others. They engage relevant stakeholders in the process and coordinate collaboratively to ensure that any necessary resources, services nad supports beyond the claims process are in place. They readliy demonstrate consideration for the ongoing needs of the Client beyond the end of the claim. They document closure conversations and actions clearly and concisely.

Case managers recognise the importance of maintaining positive engagement with the Client and key stakeholders. This perspective impacts on the way they conduct monitoring actions across all circumstances. They take a collaborative approach to problem-solving, addressing discrepancies and working through situations that do not progress as expected. They set clear expectations with the other person and ensure that contingency plans are identified and implemented in the right context and in a timely manner.

FEEDBACK

MONITORING

TERMINATION & WITHDRAWL