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This Course Awards 10 CONTACT HOURS. How Many CEU Credits Do YOU Need?
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Welcome to CEU By Net! Get Fast-Paced Online CEUs for Mental Health and Chemical Dependency (Addiction) Treatment Professionals. Get Some Ethics! Or Some Managed Care! Get some Child and Adolescent CEUs. Pass Those Treatment Record Audits.
*We Have Small Courses and Large Courses - Like THIS 10 Credit Hour Managed Care Survival Course for Only $65!
'It's Not Your Grandpa's Chevy. It's a 24-Hour Business. It's The Good, The Bad, and The Ugly. But You Can Survive It With More Gain and Less Pain. Here's How.'
For LCSWs, LMSWs, LBSWs, and Other Social Workers, LPCs, TEXAS LCDCs, MFTs, LMFTs, LSATs, LMHCs, ACPs, and More - Approved by NBCC, California BBS, Florida, Alabama and Texas, and Accepted In All Other States Which Accept NBCC-Approved Online CE Courses.
Course 10A - The Big Course On Managed Care For Professionals
This is our BEST VALUE - ONLY $65 for 10 Credit Hours and 4 Separate INSTANT Certificates! Collect them all NOW, or save some for LATER.
What do we mean, "later"? This FlexiCourse 10A has FOUR MODULES (or chapters) - each with its own certificate. You don't have to claim all of them right now; if you like, you can claim some NOW, and wait until you need the rest, for up to one year. Or take the quizzes for all, and collect TEN credits and certificates instantly ....... online, downloadable, printable, emailable, and/or save it to your computer.
This Course 10A is all about the CLINICAL AND PROGRAMMATIC ISSUES which treating clients under a contract with an insurance company or other Care Management system brings, for behavioral health providers. Required changes, new documentation, contracts, dangers and opportunities! And it's all in a fast-paced slide show format.
If you are already involved in a public sector managed care conversion, or ready to jump in, be prepared to shout YES! - or maybe NO! - as you scroll through our no-holds-barred slides and humorous artwork. Who says that Continuing Education has to be boring?
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FlexiCourse 10A is a SET of 4 MODULES (similar to CHAPTERS), awarding FOUR (4) separate CE certificates, totaling TEN (10 or 1.0) contact hours. You may earn all of the CE Certificates NOW (by taking all the quizzes), OR you may wish to DELAY earning one or more of the certificates for up to ONE YEAR after purchase of the course -- whenever you need them most! It's your choice!
- One certificate totaling 1 (or 0.1) CE Credit hour, Module 101 - "Managed Care In Public Health Programs: It's Not Your Grandpa's Chevy!"
- One certificate totaling 3 (or 0.3) CE Credit hours, Module 201 - "The Good, The Bad, and The Ugly of Managed Care - Including an Intro to Clinical and Program Options"
- One certificate totaling 1 (or 0.1) CE Credit hour, Module 301 - "Playing Mother May I . . . Welcome To Care Management! Introduction to Changes in Treatment Approach and Documentation Under a Level of Care System."
- One certificate totaling 5 (or 0.5) CE Credit hours, Module 401 - "Where The Rubber Meets The Road: How to Have More Gain and Less Pain with Managed Care."
Module 101 - 10A
'Managed Care In Public Behavioral Health Programs (Like Medicaid): It's Not Your Grandpa's Chevy!'
This online CEU course provides an unvarnished view of what has CHANGED due to the coming of Managed Care to the Mental Health (MH) and Chemical Dependency (CD) and Substance Abuse (SA) treatment fields. We include 'what can go WRONG' in the State's design of its plans, and what type of Provider Agreements to rigorously avoid.
This fast-paced colorful slide presentation gives you a basic, no-holds-barred introduction to the most common problems occurring in managed care programs which are put into place by State Government, such as Medicaid, Medicare, and Block Grant conversions - coming on strong all over the country. And a sense of what providers need to do to succeed.
Module 201 - 10A
'The Good, The Bad, and The Ugly of Managed Care, Including Clinical and Program Options for Professionals'
Are there different kinds of Managed Care plans? Yes indeed. There's The Good, The Bad, and The Ugly - for the Managed Care companies AND for the providers! But we don't just throw you out there - we identify those plans that are 'mostly safe' (like Fee for Service and Case Rates) vs. those that are 'nerve wracking' vs. those with 'don't even think about it!' written all over them.
Module 301- 10A
"Playing Mother May I - Welcome to Care Management!" The HMO's Level of Care (LOC) System . . . and How It Affects Our Documentation of What We Do and How We Do It.
These changes oftentimes involve uprooting some traditional practices that are hard to let go of - a process which is noxious to some, and impossible for others. We also present a brief introduction to some positive, creative ways that Behavioral Health Providers can 'come out of the box' in their thinking and practices - or can expand (under contract with a managed care company) the non-traditional services which they already provide to persons with serious mental illness or chemical dependency.
Module 401- 10A - 'Where The Rubber Meets The Road: How to Have More Gain and Less Pain with Managed Care, From the Start to All the Rest.'
In this Module we look at many sticky issues that treatment providers encounter when they are working within a Managed Care system. Things to beware of, things to pursue. When to say YES, when to say NO, and when to say 'How about if I do THIS?' How to avoid those 'duh!' provider errors which can cause you to lose the AUTHORIZATION to deliver treatment or be paid for it. How to collect when the MCO has erroneously denied your claim or withdrawn prior authorization for treatment. And other real-life issues like that!
Goals of the Course 10A Modules
- Module 101 - "Managed Care In Public Health Programs: It's Not Your Grandpa's Chevy!" - One certificate totaling 1 (or 0.1) CE Credit hour
1. Intro to Goals and Objectives of Behavioral Health Managed Care - 'Why are they doing this to us?'
2. What can go wrong - at both the HMO end and the Provider end.
3. Understanding 'Capitation' Contracts (the primary type of State Managed Care Contract including Medicaid) and the major way that these contracts impact mental health and substance abuse treatment providers.
4. Intro to clinical concerns and opportunities for MH and SA/CD treatment providers.
- Module 201 - "The Good, The Bad, and The Ugly of Managed Care - Including an Intro to Clinical and Program Options" - One certificate totaling 3 (or 0.3) CE Credit hours
1. Understanding the impact of this new health care approach upon providers - it's called 'Care Management'!
2. Review of 'What's a Capitation Contract' - the primary type of State-HMO managed care contract used in Medicaid and Medicare managed care conversions. Can it possibly work? Yes. And what about FEE FOR SERVICE?
3. Understanding a couple of other Managed Care designs - one is The Good, and one The Truly Ugly (Watch Out! Run Fast!)
4. And 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.)
5. How does Managed Care (and the 'Care Management' process) affect the way that we deliver treatment to Mental Health and Chemical Dependency clients? Here's some creative service options for treatment providers which allow more autonomy.
- Module 301 - " Playing Mother May I . . . Welcome To Care Management! Introduction to Changes in Treatment Approach and Documentation Under a Level of Care System." - One certificate totaling 1 (or 0.1) CE Credit hour,
1. Understanding the Four Core Principles which guide the HMO's decisions about whether to APPROVE or DENY our request to treat our client.
2. How to DOCUMENT what you do and why you do it, according to these four Core Principles - and in the process, AVOID RECOUPMENT of the fees which you have already been paid, and avoid losing the AUTHORIZATION to provide treatment to the client.
3. The value and perils of working with other network providers, as part of Managed Care. And yes, it DOES affect the quality of the care we provide and the options which we can provide to our clients.
- One certificate totaling 5 (or 0.5) CE Credit hours, Module 401 - "Where The Rubber Meets The Road: How to Have More Gain and Less Pain with Managed Care."
1. Review of "How The Managed Care Company Thinks - What Is 'Medical Necessity of Treatment' At A Practical Level" . . . i.e., how and why they make those sometimes frustrating treatment decisions that may conflict with our clinical beliefs about what is needed.
2. Why DOCUMENTATION in your clients' records must reflect all of these 'LOC decision' factors. Why documentation must be 'clinical' in its content.
3. How to work within a MCO Care Management system and contract - how to deal with multiple issues which affect the treatment we are allowed to provide to clients and the funding we receive to do it.
4.. What to do about erroneous CLAIMS DENIALS, and how to AVOID making ERRORS that cause providers to lose AUTHORIZATION to provide treatment.
5. Specific EXAMPLES of creative ways that we can serve our CD and MH clients under a Managed System of Care.
WANT A FAST TO-THE-POINT DESCRIPTION of the other courses we offer? Just hop on over to our course catalog now and take a look. If you want a detailed look at any course you see there, just click the link in the catalog and we'll take you there.
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NOTE: If you want to get more information about how DOCUMENTATION of treatment must change under managed care, consider MiniCourse 2B - 'They're Coming To Audit WHEN?' a.k.a. 'What Can Go Wrong In That Chart!' In MiniCourse 2B we also give a detailed prescription for how you can 'audit' your own records before the HMO auditors hit the door!
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