The Managed Care Catalog
Our Managed Care courses focus upon the oftentimes 'nerve-wracking' scenarios brought about by the new 'Managed Health Care' scene - and might well be called 'Quick and Easy Recipes for Managed Care Success' . . . or 'How To Survive It', depending upon your mood!
These courses are designed for those who are (or will be) providing treatment under a contract with a Managed Care company (such as an MCO and HMO) or other type of 'Care Management' organization or government contractor ... including private insurance carriers.
How many credit hours do these courses award? From 1 hour to 10 credit hours (and our 10-credit Course 10A is only $65). Some of these Managed Care courses (FlexiCourses 4A, 5A, 8A, and 10A) are organized into convenient modules or chapters which allow you to collect a certificate for each separate module - collect all now, or save some for later when you need them! Just click the + sign next to any course that you want to know more about, below.
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Course 2B - They're Coming to Audit WHEN? |
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Earn a certificate for 2 or 0.2 credits immediately upon completion of this module.
Only $19.50
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Course 2B - 'They're Coming to Audit WHEN?' - a.k.a, 'What Can Go WRONG in That Chart?'
[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. 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.
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Course 2C - We Have to Change WHAT? |
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Earn a certificate for 2 or 0.2 credits immediately upon completion of this module.
Only $19.50
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Course 2C - Intro to Professional & Clinical Issues in Managed Care - Necessary Shifts in Program Design and Treatment Approach
Some of this course's material (related to managed care goals, how managed care companies THINK, and how we have to change what we write in treatment records) overlaps 2B material . . . but then moves ahead to include professional, clinical, and programmatic CHANGES in store for professionals who are working under a Managed Care Provider Agreement. Want more credits? 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).
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Course 3A - Managed Care - Is There Anything GOOD About It? |
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Earn a certificate for 3 or 0.3 credits immediately upon completion of this module.
Only $25.00
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Course 3A - Managed Care - Is There Anything GOOD About It? a.k.a., 'The Good, The Bad, and The Ugly of Providing Treatment Under Managed Care - The Perils and The Good Stuff.'
[3 CREDIT HOURS] All of the material in 1B and 1C is included, and then we expand on the clinical opportunities and perils for providers. We attempt to put to rest the question, 'So Is there really anything GOOD about Managed Care for Mental Health and Chemical Dependency professionals?' Oh yes indeed, there is! We take a look at what contract and treatment opportunities to pursue (and which to avoid) when you work with an HMO or other managed care administrator - what types of treatment fit with a managed care system - and how innovative, non-traditional treatment services (especially for children and adults with major mental illness) can be provided under the new managed care models for difficult high-risk clients. NOTE: The material in this mini-course is very similar to MODULE 201 which also awards 3 credit hours (201 is found in FlexiCourses 4A, 5A, 8A, and 10A) . What's the difference? The FlexiCourses have additional material and more credits!
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Course 3B - Addiction & Substance Abuse Treatment - 'The Big Transition' |
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Earn a certificate for 3 or 0.3 credits immediately upon completion of this module.
Only $25.00
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Course 3B - The Big Transition in the AOD Field: Assessment of ‘Need for Treatment’ and 'Treatment Interventions' - How They've Changed!
[3 CREDIT HOURS] In most states, it's goodbye to flexible addiction Block Grants and other 'open access' State contracts! This course addresses the 'nitty gritty' of the major CHANGES in TRADITIONAL SA-CD PROGRAMS, TREATMENTS, AND PHILOSOPHY, due to the new health care environment. Applies to single AOD diagnosis and to Dual MH-AOD diagnoses.
Offers a bird's eye view of how ASSESSMENT of the client's NEED FOR TREATMENT - and HOW we DELIVER the treatment - have CHANGED under Managed Care, and how to constructively adapt when it's ethically possible. Course 3B presents some specialized treatment scenarios which can be discussed with an MCO or other care manager (State or local, etc.) which can provide effective treatment of recidivistic addiction clients, under a 'Care Management' system.
We also provide an understanding of HOW the MCOs make those controversial treatment DECISIONS for substance abusing and chemically dependent individuals - and HOW TO ASK for 'WHAT' from the MCO's care manager, to maximize your chances of getting what your clients need.
Clear 1-2-3 guidance on how to DOCUMENT both your assessment and the treatment you deliver under a Care Managed system - and an introduction to RECOUPMENT-PROOFING your professional documentation, which fits in 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.
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Course 5B - Managed Care Contract? Survive It, Professionally! |
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Earn a certificate for 5 or 0.5 credits immediately upon completion of this module.
Only $42.50
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Course 5B - Where The Rubber Meets The Road: The Nitty Gritty of How To Have More Professional Gain and Less Pain From Those Managed Care Companies!
[5 CREDIT HOURS] Same as Module 401 in FlexiCourses 8A and 10A. Negotiating for good professional and clinical options and needed changes in contracts (even after the ink is dry on your basic Provider Agreement); how to collect on denied claims and dealing with HMO claims errors; and how to avoid those 'duh!' errors that can cost you dearly. When to say NO to an MCO, when to say YES, and when to say 'How about if I do THIS?' Examples of some GREAT service options to pursue with a managed care company, including CREDENTIALING flexibility.
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FlexiCourse 5A - Welcome to Care Management! Do They REALLY Need Treatment? |
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FlexiCourse 5A - Welcome to Care Management! a.k.a., 'Do They REALLY Need Treatment?'
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[5 CREDIT HOURS in 3 CERTIFICATES] Provides a clear view of HOW the MCOs make those CARE MANAGEMENT treatment decisions, and how you can deal with it. Working with your clients' insurance companies (particularly those whose business is based upon CARE MANAGEMENT, or UTILIZATION REVIEW) requires a significant SHIFT in how we APPRAISE client's NEED FOR TREATMENT, and in your TREATMENT APPROACH. Applies to both Mental Health and Chemical Dependency (Addiction) Treatment Providers. New program approaches. New ways to document treatment. How to successfully play 'Mother May I?' with the Health Plan contractor. How to be maximally EFFECTIVE and avoid much frustration, through PROFESSIONAL and CLINICAL changes in PROGRAM DESIGN and TREATMENT APPROACH.
NOTE: Don't need 5 Credit Hours? You will find some of this information in FlexiCourse 4A (minus the more-clinical info). Bite-sized portions of this course are also found in MiniCourses 1B, 1C, and 3A. And you'll find all three of the Course 5A modules in our big FlexiCourse 10A. Why do we do this? Because one size doesn't fit all!
5 (or 0.5) CE credits for $42.50
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You're buying FlexiCourse Modules 101, 201 and 301 together, in this course 5A! You save $16.50 when you combine them! (see Module descriptions below)
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Module 101 - FlexiCourse 5A
Managed Care in Public Programs: It's Not Your Grandpa's Chevy!
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Earn a certificate for 1 or 0.1 credits immediately upon completion of this module.
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Module 201 - FlexiCourse 5A
The Good, The Bad, and The Ugly of Managed Care Contracts - Including Clinical and Program Options for Professionals
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Earn a certificate for 3 or 0.3 credits immediately upon completion of this module.
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Module 301 - FlexiCourse 5A
Welcome to Care Management! More On the Professional & Clinical Issues In Managed Care ..... How MCOs Make Those Treatment Decisions, and How To Deal With It.
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Earn a certificate for 1 or 0.1 credits immediately upon completion of this module.
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FlexiCourse 4A - This Is Managed Care - and Its Impact on YOU! |
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FlexiCourse 4A - This Is Managed Care - and It's Impact on YOU! ('The Little Managed Care Course' Modules 101 & 201)
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[4 CREDIT HOURS IN 2 CERTIFICATES] FlexiCourse 4A contains the first 2 modules from FlexiCourse 10A. What's in this course? It's a to-the-point, fast-paced ride through The Good, The Bad, and The Ugly of Managed Care. An unvarnished view of WHAT HAS CHANGED for MH and CD providers with the coming of managed care, including what can go WRONG in the State's design of its plans, and what type of Provider Agreements to AVOID. An intro to adjustments we must make in how we pay for and provide treatment. Also presents an intro to some POSITIVE, CREATIVE ways that providers can add to their basic contracts with HMOs.
NOTE: Includes Modules 101 and 201 (below). Collect both certificates now, or save one for later! Bite-sized portions of this course are found in MiniCourses 1B, 1C, and 3A.
4 (or 0.4) CE credits for $32.00
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Buy FlexiCourse Modules 101 and 201 Together! You save $7.50 when you combine them! (see Module descriptions below)
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Module 101 - FlexiCourse 4A
Managed Care in Public Programs: It's Not Your Grandpa's Chevy!
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Earn a certificate for 1 or 0.1 credits immediately upon completion of this module.
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Module 201 - FlexiCourse 4A
The Good, The Bad, and The Ugly - Including Good and Bad Options for Providers
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Earn a certificate for 3 or 0.3 credits immediately upon completion of this module.
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FlexiCourse 8A - Delivering Treatment Under Managed Care - YES, NO, or How About If I Do THIS?' |
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FlexiCourse 8A - Delivering Treatment Under Managed Care - YES, NO, or How About If I Do THIS?' - Modules 201 and 401
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[8 CREDIT HOURS in 2 CERTIFICATES] Collect both certificates now, or save one for later! What's in this course? Like parts of Courses 4A and 5A, you get a to-the-point, fast-paced ride through The Good, The Bad, and The Ugly of Managed Care (for the MCO, for YOU, and for your CLIENTS). An unvarnished view of WHAT HAS CHANGED for MH and CD treatment providers under a managed system of healthcare - changes in the TREATMENT we deliver and how we DOCUMENT It! Who we can treat and for how long and at what Level of Care. Understanding CARE MANAGEMENT and 'MEDICAL NECESSITY', and how to cope with it constructively. What type of provider arrangements to AVOID, and which to GRAB. An intro to some POSITIVE, CREATIVE ways that providers can deliver treatment to their clients within a Managed System of Care. Things to BEWARE of in your MCO agreement, things to ask for which will give you more flexibility in delivery of treatment. New creative low-risk options to serve your clients better within the new system. How to COLLECT YOUR MONEY when the HMO has denied a claim erroneously.
NOTE: Bite-sized portions of this course are found in MiniCourses 1B, 1C, and 3A. Module 401 in this course is exactly the SAME as MiniCourse 5B. If that's all you want, pick 5B! And you will find both of these Modules 201 and 401 in our big ten-hour FlexiCourse 10A.
8 (or 0.8) CE credits for $47.50
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Buy FlexiCourse Modules 201 and 401 Together - as FlexiCourse 8A! You save $20.00 when you combine them! (see Module descriptions below)
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Module 201 - FlexiCourse 8A
The Good, The Bad, and The Ugly of Managed Care - Including Clinical and Program Options for Professionals
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Earn a certificate for 3 or 0.3 credits immediately upon completion of this module.
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Module 401 - FlexiCourse 8A
'Where The Rubber Meets The Road: How To Have More Gain and Less Pain From Managed Care.'
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Earn a certificate for 5 or 0.5 credits immediately upon completion of this module.
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FlexiCourse 10A - The Big Course On Managed Care For Professionals |
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FlexiCourse 10A - The Big Course On Managed Care for Professionals (Modules 101, 201, 301, & 401)
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[10 CREDIT HOURS in 4 CERTIFICATES] flexiCourse 10A is a fast-paced slide-show course which pulls together ALL of the material found within our FlexiCourses. This FlexiCourse contains Modules 101, 201, 301, and 401 - awarding 10 contact hours in 4 certificates - all for $65! Collect all 4 certificates now, or save some for later! So what's in here? In short . . . a fast-paced ride through The Good, The Bad, and The Ugly of Managed Care contracts (the MCO's and YOURS). An unvarnished view of what has CHANGED for MH and CD providers with the coming of managed care. An intro to some positive, CREATIVE ways that providers can add to their basic contracts with Managed Care Companies. How to deal with a Managed Care Company (both before and after the ink on your Agreement dries). When to say YES to the MCO. When to say NO. And when to say 'How about if I do THIS?' How to COLLECT YOUR MONEY when the MCO has denied a claim erroneously. Avoiding those 'duh'-type errors that cost big bucks. The PROFESSIONAL and CLINICAL issues, and the necessary shifts in PROGRAM DESIGN and TREATMENT APPROACH.
Note: Bite-sized portions of this comprehensive course are found in MiniCourses 1B, 1C, 3A, and 3B. And Module 401 is the SAME as MiniCourse 5B. If that's all you want, pick 5B! [NOTE: A clear 1-2-3 approach to passing an MCO's AUDIT OF YOUR RECORDS is found only in MiniCourse 2B!]
10 (or 1.0) CE credits for $65.00
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Buy FlexiCourse Modules 101, 201, 301 and 401 Together! You save $36.50 when you combine them! (see Module descriptions below)
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Module 101 - FlexiCourse 10A
Managed Care in Public Programs: It's Not Your Grandpa's Chevy!
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Earn a certificate for 1 or 0.1 credits immediately upon completion of this module.
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Module 201 - FlexiCourse 10A
The Good, The Bad, and The Ugly - Understanding That HMO 'Capitation' Thing, It's Impact Upon YOU, and Clinical Contract Options for Providers
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Earn a certificate for 3 or 0.3 credits immediately upon completion of this module.
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Module 301 - FlexiCourse 10A
Playing 'Mother May I?' with the MCO. Welcome to Care Management! How MCOs Make Those Treatment Decisions, and How To Deal With It.
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Earn a certificate for 1 or 0.1 credits immediately upon completion of this module.
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Module 401 - FlexiCourse 10A
MiniCourse 5B - Where The Rubber Meets The Road: How To Have More Gain and Less Pain with Those Managed Care Contracts, From The Start To All The Rest
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Earn a certificate for 5 or 0.5 credits immediately upon completion of this module.
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Course 1B - Managed Care Overview |
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Earn a certificate for 1 or 0.1 credits immediately upon completion of this module.
Only $14.50
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Course 1B - It's Not Your Grandpa's Chevy - Intro to Goals, Clinical Concerns, and Opportunities In Managed Care
[1 CREDIT HOUR] An intro to how behavioral health care has changed, and 'why they are doing this to us'. The basic changes that managed care brings to the lives of providers, and a clear picture of what can go wrong in a state's new managed care plan. You'll see some of this material in FlexiCourses 4A, 5A, 8A, and 10A. What's the difference? The FlexiCourses have additional material and more credits!
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Course 1C - That 'Capitation Thing' and YOU! |
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Earn a certificate for 1 or 0.1 credits immediately upon completion of this module.
Only $14.50
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Course 1C - Understanding That State or Managed Care Company 'Capitation' Thing - AND How It Impacts Providers!
[1 CREDIT HOUR] Some of the same introductory material as in 1B, but also explains how these managed care contracts work - i.e., should providers take on ANY of these high-risk arrangements, working as a provider for an HMO? Or as the 'substitute' for an HMO? What kind of risk are they taking? And can they succeed in any of these arrangements? (Answer: Yes.) Also, 'which' contract designs have 'which' major implications for providers. Want more credit hours? This is a 1 hour course. You'll see some of this material in FlexiCourses 4A, 5A, 8A, and 10A. What's the difference? The FlexiCourses have additional material and more credits!
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