When available, the Online Course format is included with the hard copy, eBook, or audio book formats!
Release Date: April 24, 2017
Expiration Date: January 31, 2020
Nurses with expertise in wound care and those who obtain advanced certification provide direct care and are called on to advise and educate colleagues and members of the multidisciplinary team. Changes in care based on evidence from research, regulatory changes requiring quality outcomes to be measured, and a reimbursement culture that demands assessment, documentation, and progress for payment all affect nursing practice with the central goal of providing the best care for each patient. While much of wound care nursing focuses on the clinical aspect of caring for a patient, the wound care nurse must also recognize the importance of non-clinical issues, such as reimbursement, education, and legislation.
Reimbursement issues are always an important component of healthcare services. The process of coding and documentation for obtaining reimbursement is ever changing and complex. This requires nurses to stay current in regulatory changes, use the specific language required to document accurately, and work with coding professionals and the quality management team. Selecting wound care materials and resources that best address the wound type, as well as the ongoing assessment and evaluation of a wound with documentation supporting the plan of care and any changes, are key nursing responsibilities.
Nurses should also be aware of the various ways education may be obtained in wound management and understand evidence-based practice. Finally, it is vital for wound care nurses to be knowledgeable of the legalities surrounding wound management, including licensure laws, government regulations, organization policies, and practice standards that affect wound care methods.
This course reviews the general practices of reimbursement payors, including Medicare, Medicaid, and HMOs, and provides general information that can be used to make the reimbursement process more successful. (Note that this course does not discuss billing or reimbursement practices in detail because this will vary across the country.) Education, evidence-based guidelines or standards of care, and legal issues are also discussed.
After taking this course, nurses (including certified case manager nurses) will apply information relative to the various reimbursement processes and the requirements to obtain payment when providing wound care services to their own practice. The nurse will also be informed about educational advancement in the specialty and understand the need to know any scope of practice limitations and the legal implications when providing wound care services across settings.
This course is an extract of, and should not be taken in conjunction with N1737 - Wound Management: A Comprehensive Guide for Nurses.
This course has been submitted to the Commission for Case Manager Certification for approval to provide board certified case managers with 2 clock hours.
- Understand the reimbursement process when managing wounds and issues related to nursing professional practice.
- Describe payor sources available for wound care services and steps that can be taken to assist in successful reimbursement.
- Discuss topics related to the professional practice of wound management, including education, certification, evidence-based practice, and legal concerns.
Linda Stricker, MSN, RN, CWOCN, has over 25 years of experience in wound, ostomy, and continence (WOC) nursing. She earned her Bachelor of Science degree in nursing from the University of Akron and a Master of Science degree with a minor in education from the University of Phoenix. She is the current program director of the R.B. Turnbull, Jr. MD School of WOC Nursing Education at Cleveland Clinic. Linda also serves the Wound Ostomy Continence Nurses Society™ in a variety of roles and is the current President-elect of the WOCN® Mideast Region. She has authored or coauthored publications on stoma construction, fistula management, and WOC nursing subjects, and presented on a variety of wound management topics.
- Courses must be completed on or before the expiration date noted in the course description above.
- You must score 75% or higher on the final exam and complete the course evaluation to pass this course and receive a certificate of completion.
- Through our review processes, Western Schools ensures that this course content is presented in a balanced, unbiased manner and is free from commercial influence. It is Western Schools’ policy not to accept commercial support.
- All persons involved in the planning and development of this course have disclosed no relevant financial relationships or other conflicts of interest related to the course content.