Online CEU Course 5A for Social Workers (LCSW, LMSW), Counselors (LPC, LMHC, LSAT), MFTs and LMFTs - 5 Credit Hours!
FlexiCourse 5A - "Welcome To Care Management! Do They REALLY Need Treatment?"
That Infamous Care Management Process! 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. Here's How.
FlexiCourse 5A (five contact hours) contains the first 3 modules from FlexiCourse 10A. Bite-sized portions of this course are found in MiniCourses 1B, 1C, and 3A.
We're Approved for CEUs In California (BBS) and Texas - and Accepted in Indiana, Arizona, Idaho, Georgia, Virginia, and District of Columbia!
WANT 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 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!
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 - this 5-unit online self/home study 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. If new to Managed Care, 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 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.
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:
- One CE certificate totaling 1 (or 0.1) CE Credit, "Module 101 - Managed Care In Public Health Programs: It's Not Your Grandpa's Chevy!" . . . and
- One CE certificate totaling 3 (or 0.3) CE Credits, "Module 201 - The Good, The Bad, and The Ugly of Managed Care Contracts, Including Clinical and Programmatic Contract Options for Professionals"
- One CE certificate totaling 3 (or.3) CE Credits, "Module 301 - 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."
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.
Module 101
Managed Care In Public Health Programs: It's Not Your Grandpa's Chevy!
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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 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.
Module 201
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.
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! 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 or .5 CE Credits). AND . . . If you want to get an in-depth view of 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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CEU By Net's Continuing Education Courses meet the CE requirements of the State Boards of Texas, Arizona , District of Columbia, Georgia, Idaho, Indiana, and Virginia for designated licenses. Other States may approve our courses because we are certified by the Texas State Boards which regulate Social Work, Licensed Professional Counselors, Marriage and Family Therapists, and LCDCs. Check with YOUR state board regarding approval of our Continuing Education (CEU) Courses!
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