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Welcome to CEU By Net - and 'Welcome to Care Management' - a 5 Credit Hour Continuing Education [NOTE:  This course is temporarily off-line]

Of course she needs treatment!Online CEU Course Course 5A Is for AOD and Mental Health Counselors, Social Workers, and MFTs - 'Welcome To Care Management! Do They REALLY Need Treatment?'  5 Credit Hours!

What's This Course 5A About? 

Understand That Infamous 'Care Management' and 'Utilization Review Process' which is now inherent in Health Care Reform! It Requires A Significant Shift In Treatment Approach By Mental Health and Chemical Dependency Providers. New Approaches to Programming and to Documentation of the Treatment. And You Have To Play 'Mother May I?' with the Managed Care Company. It's Painful to Some, Impossible for Others - But  Here's How to Do It, and to Understand It.  

FlexiCourse 5A (five clock hours of CE Credit) contains the two modules found in Course 4A, plus one addtional credit hour.  Bite-sized portions of this course are found in MiniCourses 1B, 1C, and 3A.  


need_fast_description_of_coursesWANT A FAST TO-THE-POINT DESCRIPTION of what's covered in this 5 HOUR COURSE? Just hop on over to our Course Catalog now and take a look. If you want a more detailed look at this course, just click the link in the catalog and we'll bring you right back to this page. Or just read on!  

APPROVALS:   We're Approved for CEUs by NBCC, EACC-EAPACalifornia BBSFlorida, Alabama, and Texas - and Accepted in Almost Every State for Most Licenses.

Note:  FOR THE DEFINITION OF 'CEU' and 'PDH' when earned on this site, CLICK HERE. 



survive_managed_care

If you are a social worker, LPC, MFT, or other mental health or substance abuse treatment provider - and are involved in or concerned about Managed Care under the new Health Care Reform - this 5 credit hour online Continuing Education (CE) course is timely and relevant. Get a clear view of the upside and downside of Managed Care from the provider's perspective.  Know what you are getting into and what you may need to change about how you do treatment and document it in treatment records.

OR if you are already 'in' Managed Care, know where there may be some untapped contracting options for providers (and which are safe and which are not). Get some proven tips on how to avoid RECOUPMENT of funds by the HMO through your approach to Care Management and what you write in treatment records. And get a clear understanding about the 4 Core Elements that drive those Care Management decisions to approve or deny your treatment requests.  

This online CEU Course 5A provides an unvarnished view of what has CHANGED due to the coming of Managed Care to the Mental Health (MH) and Chemical Dependency (CD) treatment fields.

We summarize the clinical and programmatic changes (and sometimes painful adjustments) which providers must make in order to comply with Managed Care contracts. And we tell you why managed care companies 'do what they do' in decisions about patient care (to authorize the request for treatment or to deny it) - and how you can deal with this to get what your client needs.

  

FlexiCourse 5A contains the course materials for three (3) separate CE certificates:

You may earn all three CE Certificates now, 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!

The course also discusses what can go wrong in a State's Managed Care Plan - things that cause confusion and trouble for both the HMO and the behavioral health provider. And which types of Provider Agreements or Contracts are worth a shot, vs. those that have 'Don't even think about it!" written all over them.

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 Module 101  

 Goals and Objectives of Behavioral Health Managed Care

MC 101 - Managed Care In Public Health Programs: 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.

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. 

This 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 or Federal Government, such as Medicaid, Medicare, and Block Grant conversions . . . coming on strong all over the country.

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Module 201  

MC 201 - The Good, The Bad, and The Ugly of Managed CareThe 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.   

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.  

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Module 301

MC 301 - documentation_is_key"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.  

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!

3. The value and perils of working with other network providers, as part of Survival of Managed Care.

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NOTE: If you want to learn more about creative ways to contract with an HMO, and out-of-the-box treatment options under managed care, consider purchasing MiniCourse 5B (5 clock hours of CE Credit).

AND . . . If you want to get an in-depth view of how documentation of treatment must change under managed care, consider Course 2B - 'They're Coming To Audit WHEN?' a.k.a. 'What Can Go Wrong In That Chart!' In Course 2B we also give a detailed prescription for how you can 'audit' your own records before the HMO auditors hit the door!

AND . . . For a clearer picture of how HMOs make those treatment decisions - and apply these principles when they audit your records - consider MiniCourse 2C.

CEU By Net's Continuing Education Courses meet the CE requirements of most states  for designated licenses - and we are certified by Texas, California, Alabama, and Florida for Counselors and Social Workers and MFTs. Other States may approve our courses because we are certified by NBCC and EACC, and the Texas State Boards which regulate Social Work, Licensed Professional Counselors, Marriage and Family Therapists, and Certified Addiction Professionals (TCBAP-TAAP)  - and by the State Boards of California, Alabama, and Florida. Check with YOUR state board regarding approval of our Continuing Education (CEU) Courses!  

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We're  CEU By Net!

Providing Dependable and Affordable Online Continuing Education
For Discriminating Behavioral Health Professionals

http://www.ceubynet.com

 

All content on this site is Copyright (c) 2006-2015 by Pendragon Associates and/or CEU by Net

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