Course 2B - 'They're Coming to Audit WHEN?' - a.k.a, 'What Can Go WRONG in That Chart?'

$17.50 - [2 CREDIT HOURS] Want to pass that TREATMENT RECORD AUDIT? Want to avoid RECOUPMENT of claims payments already paid to you, when the MCO calls for a client's record, or their auditors show up at your door? Here's how! This fast-paced slide show clearly describes 'what's DIFFERENT' about how we must DOCUMENT TREATMENT in MH and CD/AOD client records today, under the new behavioral health contracts. And we give you useful and do-able tips on how to audit your own records - so that you are ready BEFORE the MCO or State auditor arrives.

For example, we tell you how to avoid 12 deadly 'documentation syndromes' which will sabotage even the best clinicians working within the new Behavioral Health Care Reform initiative .... including The ‘POORLY DOCUMENTED LEVEL OF CARE’ Syndrome, The ‘ZOMBIE CLIENT’ Syndrome, The ‘PERPETUAL CARE’ Syndrome, The ‘ANY-PATIENT ITP’ Syndrome, The ‘FAILURE TO MODIFY’ Syndrome, and several more.

This valuable course also provides a clear explanation about HOW managed care contract administrators make pre-authorization decisions to approve or deny your requests for treatment .... and WHAT you must write in the client's chart to support that authorization.

Ethics 4D - When Insurance and State Contracts Are Paying the Bill – The Ethics of Treatment Documentation and Other Ethical Dilemmas in Today’s World.

$28.00 - A Four (4) Credit Hour Ethics Course Approved/Accepted for Professional Counselors, MFTs, Social Workers, Substance Abuse Counselors, EAP providers, and other behavioral health practitioners in ALMOST EVERY STATE.

Ethics 4D is a fast-paced SLIDESHOW with content that's easy to understand and never boring - regarding the ETHICAL DILEMMAS (and pressures) encountered on a daily basis by those whose clients' fees or services are paid by insurance, managed care, Employee Assistance Programs, self-insured companies, or other closely monitored state or local contracts.

NOTE: Ethics 4D contains the same core material as the 3 credit-hour Ethics Course 3D, except that 4D includes additional material regarding these ethical issues.

This course is a close-up view of that sticky issue ... what to write (and not write) in a client's treatment record, from an ETHICS perspective, in this new era of tightly controlled health care costs. How much do you divulge about your ASSESSMENT of the client's DIAGNOSIS(ES), his prognosis, his functional status, and his response to treatment? What's ETHICAL - when the payor is demanding details? What's NECESSARY?

Is such scrutiny legitimate and ethical, or is it an invasion of your (and your client's) privacy? And is it ethical to provide the requested information? Do most states’ licensure standards SUPPORT - or OVERRULE - this type of documentation of a client's treatment information? The answer may surprise you.

SUMMARY OF GOALS:

1. Understand the ETHICAL AND PRACTICAL impact of CARE MANAGEMENT upon WHO gets treatment or related services, WHAT treatments and related services they may receive, and HOW MUCH of each intervention is allowed.

2. Identify the ETHICAL ISSUES faced by providers due to this new approach to authorization - in both the delivery of treatment or related services AND in the DOCUMENTATION of the ASSESSMENT, DIAGNOSIS, and RESPONSE TO TREATMENT OR INTERVENTION.

3. Learn how we can ETHICALLY accommodate these new service and documentation requirements, while simultaneously meeting the requirements of our Provider Agreements.

4. Identify additional ETHICAL DILEMMAS encountered in assessment and treatment of mental health and substance abuse clients, including the ethics of the Quality Management - Treatment Effectiveness scrutiny which HMOs and other such contract managers place upon the work we do. Is it ETHICAL activity, or is it invasive?

[Want to watch a short Ethics COURSE DEMO, with material from Ethics 4D and 3D? Click the Ethics Course Preview here.]

Course 3C - Beyond the Yellow Legal Pad! Biopsychosocial and Risk Assessment of CD and MH Minors

$24.00 - [3 Credit Hours] THIS IS A PDF DOCUMENT which can be viewed with Adobe Reader or any other pdf reader program.

Move 'beyond the yellow legal pad' when assessing and diagnosing children and adolescents with CD-SA and Mental Health issues. Protect yourself from legal vulnerability, through documented competent assessment and treatment planning, particularly when working with children and adolescents who present a potential for harm to self or others. NOTE: The basic assessment principles in this course apply to adult clients as well as to youth - including in particular the PROCESS OF RISK ASSESSMENT.

Assessment Course 3C addresses serious assessment ERRORS to avoid, which can result in LEGAL complications and PROFESSIONAL LIABILITY issues. Understand the implications of erroneous or ignored DIAGNOSIS and failure to respond to regression or failure to progress.

The course presents a structured, 1-2-3 approach to Mental Health and Substance Abuse (AOD) Assessment of minor clients - emphasizing and demonstrating the features of assessment which facilitate a CORRECT DIAGNOSIS and APPROPRIATE TREATMENT PLANNING. It comes with a FREE DOWNLOADABLE ASSESSMENT FORMAT! Includes critical assessment and diagnostic ERRORS to avoid which can result in legal complications and professional liability issues.

Also includes a structured approach to RISK ASSESSMENT of a child or adolescent - including a short, easy-to-use FREE downloadable Risk Assessment Form.

GOALS of COURSE:

1. Learning which omissions and errors in Biopsychosocial Assessment of Children and Adolescents can leave the assessor vulnerable to legal liability in the event of an adverse treatment outcome.

2. Understanding how inadvertent omissions can adversely impact the correctness of diagnosis and the details of the treatment plan.

3. Learning to spot your own flawed documentation patterns which lead to audit woes and legal problems.

4. The details of competent ‘Assessment of Acute Risk’ with children and adolescents.


And, for you TEXAS professionals, the course and the assessment content FULLY SUPPORT YOUR TEXAS' TDSHS UA requests for children and adolescents. Be documented beyond question in that child's chart!

Get FREE Downloadable Forms which you can tailor to your own needs if you have software to modify pdf documents.

NOTE: This course is a PDF DOCUMENT (Acrobat Reader) - not a slide show like some of our other courses.

View the quiz now, for FREE, by clicking HERE.

You can print the quiz before you begin to view the course materials - mark answers as you move through the document - and then pass the online quiz on the first try.

Course 2C - Intro to Professional & Clinical Issues in Managed Care - Necessary Shifts in Program Design and Treatment Approach

$17.50 - [2 Credit Hours] For Mental Health and Chemical Dependency Treatment Providers. Some of this course's material overlaps 2B material (related to managed care goals, how managed care companies THINK, and how we have to change what we write in treatment records) . . . but then the course moves ahead to include professional, clinical, and programmatic CHANGES in store for professionals who are working under a Managed Care Provider Agreement.

GOALS:

1. Overview of basic goals of managed care -- 'Why Are They Doing This To Us?'

2. Understanding The Impact Of The New Healthcare Industry Goals Upon Us (The Providers) and Our Clients.

3. How To Think Like A Managed Care Company Or Care Management Organization (It's Essential For Survival) – Understanding What Drives Those 'Level Of Care' (LOC) Decisions!

4. How the Insurance Company or Plan Administrator’s RISK Affects Providers In Their Professional Operations -- The Positives, The Challenges, and Examples Of Creative Service and Treatment Approaches.

5. Provider Networks As A Way To Survive The Shifts – Referral and Sharing the Task of Service Delivery
Are you interested in this material, but want more credits than this course offers? Some of this material appears in MiniCourse 3A (3 credit hours total), and in FlexiCourse 5A (5 credit hours), and FlexiCourse 10A (10 credit hours).

Ethics 3D - When Insurance and State Contracts Are Paying the Bill – The Ethics of Treatment Documentation in Today’s World.

$24.00 - A Three (3) Credit Hour Ethics Course Approved/Accepted for Professional Counselors, MFTs, Social Workers, Substance Abuse Counselors, EAP providers, and other behavioral health practitioners in ALMOST EVERY STATE.

Ethics 3D is a fast-paced SLIDESHOW with content that's easy to understand and never boring - regarding the ETHICAL DILEMMAS (and PRESSURES) encountered on a daily basis by those whose clients' fees or services are paid by insurance, managed care, Employee Assistance Programs, self-insured companies, or other closely monitored state or local contracts.

NOTE: Ethics 3D contains the same core material as the 4 credit-hour Ethics Course 4D, except that 4D includes additional material regarding these ethical issues.

This course is a close-up view of that sticky issue ... what to write (and not write) in a client's treatment record, from an ETHICS perspective, in this new era of tightly controlled health care costs. How much do you divulge about your ASSESSMENT of the client's DIAGNOSIS(ES), his prognosis, his functional status, and his response to treatment? What's ETHICAL - when the payor is demanding details? What's NECESSARY?

Is such scrutiny legitimate and ethical, or is it an invasion of your (and your client's) privacy? And is it ethical to provide the requested information? Do most states’ licensure standards SUPPORT - or OVERRULE - this type of documentation of a client's treatment information? The answer may surprise you.

SUMMARY OF GOALS:

1. Understand the ETHICAL AND PRACTICAL impact of CARE MANAGEMENT upon WHO gets treatment or related services, WHAT treatments and related services they may receive, and HOW MUCH of each intervention is allowed.

2. Identify the ETHICAL ISSUES faced by providers due to this new approach to authorization - in both the delivery of treatment or related services AND in the DOCUMENTATION of the ASSESSMENT, DIAGNOSIS, and RESPONSE TO TREATMENT OR INTERVENTION.

3. Learn how we can ETHICALLY accommodate these new service and documentation requirements, while simultaneously meeting the requirements of our Provider Agreements.

Course 3B - The Big Transition in the AOD Field: Assessment and Documentation of ‘Need for Treatment’ and 'Treatment Interventions' - How They've Changed!

$23.00 - [3 CREDIT HOURS] 3 Credit hours. In most states, it's goodbye to flexible addiction Block Grants and other 'open access' State contracts for substance abuse and chemical dependency – which makes access to AOD services even more difficult. This course addresses the 'nitty gritty' of the major CHANGES in SA-CD programs – referral criteria, treatments and interventions available, documentation of need for treatment and response, and philosophy – due to the new health care reform environment. Applies to single AOD diagnosis and to Dual MH-AOD diagnoses.

This course is appropriate for chemical dependency counselors, social workers, mental health counselors, marriage and family therapists, case managers, rehabilitation workers, EAP providers, school psychologists and counselors, , and others who work with persons who have AOD issues which need assessment, treatment, or referral for same.

FOR EAP COUNSELORS who may or may not be delivering the actual AOD treatment for their clients (in many programs, you will be referring and ensuring continuity rather than treating), it is nevertheless critical that you document your client’s need for treatment in the same thorough and clinically acceptable way that the treatment program must do. Otherwise, the insurance company or other behavioral health administrator will focus upon the disparity in the EAP record vs. the treatment record, and approval for services may then be at risk.

Offers a bird's eye view of how ASSESSMENT of the client's NEED FOR TREATMENT must be documented to secure an authorization, and HOW the treatment or interventions must be delivered and documented under managed systems of care ..... and how to CONSTRUCTIVELY ADAPT to these changes when it's ethically possible.

This course includes material on the following:

1. the BACKGROUND of why treatment approach and documentation of need for treatment have changed so significantly in the AOD field.

2. understanding how HMOs, BHOs, MCOs, self-insured companies, EAP provider companies, state operated plans such as Medicaid, and commercial insurance companies (i.e., managed care contractors) THINK about WHO needs treatment and WHAT kind of treatment they need ..... in other words, what are the new criteria for establishing the need for treatment, and how can we accommodate to it?

3. the role that assessment and treatment DOCUMENTATION play in obtaining and maintaining treatment authorization and funding for our clients, and learn the four KEY CONCEPTS in authorization and documentation of assessment and treatment.

4. how AOD treatment and intervention programs and individual service plans are designed, within the new health care reform environment …. and what will likely be approved by the contractor ….. and what type of programs will get the OUTCOME results that insurance carriers and state programs are looking for.

Course 3B presents some specialized treatment and case management scenarios which can be discussed with an MCO or other contractor for services, which can provide effective services and treatment to recidivistic AOD clients, under a 'Care Management' system.

Also provides an understanding of HOW the health care contractors make those controversial treatment DECISIONS for substance abusing and chemically dependent individuals - and HOW TO ASK for 'WHAT' in terms of services and/or referral for your clients with AOD issues. Maximize your client’s chances of getting what he or she actually needs, based upon competent assessment in a new health care environment.

For EAP workers who may or may not be delivering the actual AOD treatment for their clients (in many programs, you will be referring and ensuring continuity rather than treating), it is nevertheless critical that you document your client’s need for treatment in the same thorough and clinically acceptable way that the treatment program must do. Otherwise, the insurance company or other behavioral health administrator will focus upon the disparity in the EAP record vs. the treatment record, and approval for services may then be at risk.

We also present clear 1-2-3 guidance on how to DOCUMENT both your assessment and the services you deliver under a managed system of care – and an introduction to RECOUPMENT of funds already paid to you (which typically occurs due to inadequate DOCUMENTATION OF SERVICES in client records). The course explains how to AUDIT your own professional documentation, so that it fits in well with the new CARE MANAGEMENT or Utilization Review (UR) process.

Some material in this course is included in MiniCourses 1B and 1C and elsewhere, but this course does it from the AOD perspective.

THE GOALS OF THIS COURSE:

The goals of Course 3B focus upon managing change within the traditional chemical and substance dependency culture under managed systems of care, i.e., understanding how it affects our interpretation of ‘need for treatment’ and our interventions to promote sobriety.

1. Understanding the New Managed Care Treatment Contracts and How They Affect Us and Our Clients.

2. The Essential Clinical Shifts Imposed Upon the CD Treatment Professional and Traditional CD Programming, Under a Care Management System

3. Changing Expectations for Documentation in Service Records.

4. Know Some Workable and Creative Service Options Which CD Treatment Professionals May Negotiate with Health Care Contractors, Given the Provider’s Greater Autonomy In Referral and Treatment Decisions.