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Welcome to CEU By Net! Online Continuing Education CEUs for Mental Health and Chemical Dependency (AOD) Professionals. INEXPENSIVE. Never Boring. Unique Online CE Courses! Instant Online CE Certificates. Online CEU Quizzes. New 'Pay Only For Quiz' Courses.
♦ Read About Our Inexpensive, Popular 4-Credit Hour Slide Show - Geriatric Cognitive Impairment Treatment: Course 4G - and Watch the Short Preview/Demo for the Course. ♦ Tour the Ethics CE Catalog, and Watch an Ethics Course Preview. ♦ Or Go to the AOD CE Catalog. ♦ To the Managed Care CE Catalog. ♦ To the Child and Adolescent CE Catalog.
♦ Get Unlimited CEUs for $65.
♦ New 'Quiz Only' CE Courses
♦ 10-credit Managed Care CE Course $40.
♦ Browse Our Entire Program Catalog.
♦ Find YOUR State On Our States and Licensure Map
♦ View Our NBCC Online CE Provider Approval
♦ Social Worker CE State Approvals
If you are looking for inexpensive, fast-paced, online courses and INSTANT certificates - including 'Quiz Only' courses - this is the place! We offer courses in ...
♦ Addiction AOD Treatment and Issues
♦ Diagnosis and Assessment
♦ Ethics ♦ Psychotherapeutic Medications
♦ Managed Care ♦ Child and Adolescent
♦ Geriatric - Aging Treatment and Intervention
♦ Clinical Documentation ♦ Audit-Proofing Treatment Records
♦ Treatment Methodology ♦ Cultural Competency
♦ More
We now offer PDF-formatted courses as well as our dynamic Flash slide-show courses. And some new 'Quiz Only' courses, too - where we supply a link to a great online publication, and you view it and its quiz for FREE ... even print them to study offline if you like. Then pay us only if you want to take the online quiz. ♦ We also have several popular in-house slide show courses (aging, ethics, managed care, etc.) developed with fast-paced Flash Player technology! To watch an Aging Course preview or an Ethics Course preview, click HERE - very cool!
Get instant online Certificates (which you can print, download, email, and save, and re-access at any time).
Who Can Take Our Courses?
Does YOUR State Accept Our CEUS for YOUR License? Click the Interactive States Map to See! All of our fast-paced online CE Courses are NBCC certified, fully automated and available by internet 24-7 ... most in slide show format. Your mental health and substance abuse (AOD) CEU certificates are also instantly available online - no waiting for anything. Print them, save them, email them. It's that easy.
Our Online CEU Courses are pre-approved or accepted by many Social Worker Boards for continuing education - including California BBS, Florida, Alabama, and Texas. CEUs are for LCSW, LAMSW, LBSW, LMSW, LSW, LGSW, APSW, CMSW, LSCSW, CSW, LISW, LICSW, ICSW, lBSW, SWA, SWT, PCMSW, etc. We're also accepted by almost every state for LPCs and MFTs and many other behavioral health licenses including LSAT, LCDC, CSAC and more.
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Watch the Geriatric Aging Course Demo. And the Ethics Course Demo. Just click these links.
Our NBCC-approved continuing education courses are for Social Workers, LPCs, PLPCS, LSATs, CSACs, LMFTs, MFTs, LMHCs, LPCMH, LPCCs, LCMHCs, LMHPs, CPCs, LCDCs, LCDP, and other Addiction Counselors, Pastoral Counselors, Rehabilitation Counselors, and other behavioral health practitioners. Our courses are approved or accepted by most State Boards for Counselors and MFTs, as well as NBCC, and by many Social Work Boards. Click your state on the interactive map.
In addition to our Social Work CEU certifications in Texas, California, Florida, and Alabama, our instant certificates and inexpensive CEU courses also meet the criteria for acceptable online Social Worker CEUs in at least the following states: Ohio, Kansas, Idaho, Missouri, Wisconsin, Arizona, Connecticut, Wyoming, Montana, Alaska, Iowa, West Virginia, Virginia, Maine, Washington, Georgia, Nebraska, New Hampshire, Indiana, Louisiana, Pennsylvania, Delaware, District of Columbia (DC), Oregon, Tennessee, Maryland, Utah and others (including those states in which Social Workers have discretion in applicability of the course).
For details about these state approvals, or for other states not listed here, just click YOUR STATE on our interactive map.
HOP ON OVER TO OUR COURSE CATALOG NOW, IF YOU WANT A FAST NO-FRILLS DESCRIPTION of ALL of our Courses. If you want a more detailed look at a given course, just click that course link in the catalog, and we'll bring you right back to that course on this (or another) page. Or, you can just read on, below.
Aging and Geriatric Issues and Treatment Interventions.
We have two courses which pertain to treatment interventions with the geriatric population: Our new Ethics Course 2D, 'Advance Directives: Assisting with Plans for End of Life Care', and our Aging Course 4G which focuses upon cognitive decline and behavioral issues with the geriatric population. You can go directly to the catalog for these two courses by clicking the name of the course above - and you can also read about Aging Course 4G below.
Aging Geriatric Course 4G. How Do You Address Cognitive Impairment Issues in the Geriatric Population?
Need Aging or Geriatric CEUs? Then check out our new Geriatric-Aging Course, awarding 4 CEUs. [You can view a DEMO of this course by clicking HERE. Or jump to the catalog HERE.]
This course presents a STRUCTURED SKILLS-BASED TREATMENT approach to working with cognitive impairment and behavioral difficulties of the elderly. The course also helps you to ASSESS and PRIORITIZE the cognitive impairment and behavioral issues at hand.
Is it always Alzheimer's when we see a cognitively impaired and behaviorally confused elderly client appear at our door? No. And thus there are treatment interventions that can help. The interventions in this course are particularly helpful with cognitive confusion or acute cognitive impairment associated with sudden or traumatic changes or events – things like a stroke, major shift in living arrangement (e.g., a move to a nursing home, the loss of one’s personal home and possessions), death of a spouse, loss of independence (perhaps due to a stroke or surgery, or physical illness), or other external factors.
"Improving Behavior and Cognitive Functioning In the Elderly Patient, Through A Structured Skills-Based Treatment Approach." (4 CEUs) Aging 4G is a 4 hour independent study course that is unique, fast paced, and entertaining in a slide show format. Appropriate for Social Workers, Professional Counselors, Rehabilitation Counselors, and others who work with aging individuals in a variety of settings.
We present a creative and effective approach to working with cognitive and behavioral difficulties of the elderly which are encountered in private practices, mental health clinics, nursing homes, and adult day care centers.
GOALS OF THIS PROGRAM INCLUDE THESE: 1. Overview of Cognitive and Behavioral (Functional) Deficits of the non-Alzheimer's Geriatric Population. How is the cognitive and behavioral dysfunction of the AGING population different than we see with other people with such issues? 2. Specific Techniques for Reconnecting and Reinforcing Cognitive Processes in AGING INDIVIDUALS. 3. Behavioral Management Techniques Tailored To The Aging or Geriatric Patient. 4. Designing and Implementing Individualized Treatment Plans for Cognitively and Behaviorally Impaired Aging Mental Health Consumers. 5. Effective Documentation of Such Treatment
And There's More in Our Catalog!
In addition to our AGING GERIATRIC TREATMENT COURSE . . . we offer fast-paced slide show ETHICS COURSES for Mental Health and Chemical Dependency providers, and one new FREE-TO-VIEW pdf ethics course - Ethics 2D. And a new Quiz Only, FREE-TO-VIEW course on PSYCHOTHERAPEUTIC MEDICATIONS, for both MH and AOD.
One very popular course is our 3-hour Child and Adolescent Mental Health and Substance Abuse ASSESSMENT course that moves you 'Beyond The Yellow Legal Pad'. And it's a pdf document with printable forms for you.
And we have some VERY popular DOCUMENTATION courses for those who are looking to fulfill CE documentation requirements (hard-to-find). And we continue to offer great courses on 'Surviving Those New-Fangled MANAGED CARE Contracts.
. . . And take a look at our specialized Chemical Dependency Course that will take you through the 'Big Transition' in the Substance Abuse Treatment culture. And other courses for CD-SA too! (P.S. - As in many other states, Texas approves these courses for LCDCs!)
Click Here to Go to the Managed Care CEU Catalog.
How To Survive Managed Care! Whether Your Contract is Managed By the State, An MCO (HMO, BHO), a Commercial Insurance Plan or Another Entity, We've Got It! These Courses Are for Private Practitioners As Well As Those Working in the Public Sector Programs (e.g., Medicaid) For an OVERVIEW of the Managed Care courses on this page, CLICK HERE.
Like how to stay out of 'AUDIT trouble' in terms of what you write (and don't write) in those treatment records. How to avoid RECOUPMENT of money they have already paid you. Understanding how the CARE MANAGER THINKS - like when they are considering your treatment requests. Knowing what they are REALLY looking for when they ask about the enrollees' need for treatment, so you can provide that information in a way that succeeds!
Click Here to Go Back to the Catalog for Course 3C - Beyond the Yellow Legal Pad!
Biopsychosocial and Risk Assessment of Children and Adolescents - for Mental Health and Substance Abuse Treatment Professionals, Including Texas' TRAG Providers!
SUMMARY: This course focuses upon 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 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 the short, easy-to-use FREE downloadable Risk Assessment Form. Protect yourself from legal vulnerability and critical incidents when working with clients who present a potential for harm to self or others.
And, for you TEXAS professionals, the course and the assessment content FULLY SUPPORT YOUR TEXAS' TDSHS TRAG and 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.
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Some Managed Care Courses in Our Managed Care Catalog Are Described Below. Or Just Jump to the Managed Care Catalog.
Click Here to Go Back to the Catalog for Course 1B - 'Managed Care In Public Health Programs: It's Not Your Grandpa's Chevy!' - 1 Credit Hour
What's really CHANGED here? Truthfully? A lot! It's a whole new way to deliver treatment which is HIGH RISK for everyone involved - including the Managed Care Companies!
SUMMARY: This is our smallest course about Managed Care - a small 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. This is a 1 hour online CE course earning a total of 1 (or 0.1) Continuing Education unit.
Click Here to Go Back to the Catalog for Course 1C - 'Understanding That Capitation Thing - AND How It Impacts Providers!' - 1 Credit Hour
Are there different kinds of Managed Care contracts? Yes indeed. There's The Good, The Bad, and The Ugly - for the Managed Care companies AND for the providers!
SUMMARY: 'Understanding That Capitation Thing - AND How It Impacts Providers!' - Some of the same introductory material as in 1B, but also explains how these managed care contracts work at a practical level - 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. This is a hour online CE course earning a total of 1 (or 0.1) Continuing Education unit.
Click Here to Go Back to the Catalog for Course 2B - "They're Coming to Audit WHEN?"
The Managed Care Company's or State's Authorization Process and YOUR Documentation in Client Records .... a.k.a, 'What Can Go WRONG in That Chart?' - 2 Credit Hours
SUMMARY: Presents in a clear, 1-2-3 manor the changes that MH and CD professionals must make in how they DOCUMENT treatment in client records when an Insurance Company is paying for treatment, and the professional and CLINICAL ISSUES this may raise for practitioners.Also provides a clear explanation about HOW those managed care companies 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. It's all about how to ENSURE that you will be ready when the MCO or State auditors appear at your door.
AVOID RECOUPMENT! Failure to properly DOCUMENT the client's treatment and his need for treatment is the primary reason for RECOUPMENT (taking back) of funds already paid to you by the State or the MCO. How we document treatment has CHANGED with the coming of Care Management! This course gives you clear 1-2-3 information about how to document - within the bounds of GOOD PROFESSIONAL PRACTICE.
Click Here to Go Back to the Catalog, for Course 2C - "We Have To Change WHAT?"
An Introduction to Professional & Clinical Issues In Managed Care - Necessary Shifts in Program Design and Treatment Approach - 2 Credit Hours
- For Mental Health and Addiction Treatment Providers
Will providers HAVE TO CHANGE WHAT THEY ARE DOING NOW? Yes indeed they will - even if they have long since abandoned the old traditional 'talk therapy in the office' approach and the 28 day programs. Learn to THINK LIKE THE MCO (or other health care insurer, which in some cases may be the State or County health unit).
SUMMARY: This course - 'We Have to Change WHAT?' - focuses upon the IMPACT of the new healthcare industry's goals upon providers, both CLINICALLY and FINANCIALLY - Including how Provider Agreements are changing the way that we do treatment, the managed care contractor's search for new providers, the conflict between a provider's own professional beliefs and ethics vs. the insurance company's Care Management decisions about approval or denial of treatment requests.
Some material related to managed care goals and what we write in treatment records overlaps 2B material, but moves ahead to include professional, clinical, and programmatic changes in store for professionals under managed care. Includes some interesting OPTIONS FOR PROVIDERS in the design of their practices and programs, as part of an HMO contract. This is a 2 hour online CE course.
Click Here to Go Back to the Catalog for Course 3A - Managed Care - Is There Anything GOOD About It?
'The Good, The Bad, and The Ugly of Providing Treatment Under Managed Care - The Perils and The Opportunity.' - 3 Credit Hours
SUMMARY: This MiniCourse 3A takes some content from the MiniCourses 1B and 1C about how managed care plans are designed and the reasons WHY Managed Care has come into play. 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 or dual diagnosis) can be provided under the new managed care models for difficult high-risk clients.
NOTE: The final lesson in this course focuses upon the clinical details of how Care Management departments make treatment decisions which impact your clients' recovery process, and how providers can accommodate to this shift in clinical emphasis.
Click Here to Go Back to the Catalog for Course 3B - 'Substance Abuse and Chemical Dependency Treatment - The Big Transition' - 3 Credit Hours
a.k.a., "The Big Transition in the AOD Field: Assessment of 'Need For Treatment' and 'Treatment Interventions' - How They've CHANGED!'
This CE course - accepted for LCDCs in TEXAS and approved for mental health practitioners in TEXAS and CALIFORNIA - addresses the 'nitty gritty' of major programmatic, therapeutic, and philosophical changes taking place within the traditional Alcohol and Other Drug (AOD) treatment culture, due to a new health care environment. Material applies to single AOD diagnosis and to Dual MH-AOD diagnoses.
The course offers a bird's eye view of how ASSESSMENT of the NEED for TREATMENT - and HOW we DELIVER treatment - have changed under Managed Care and other insurance plans . . . and how to constructively adapt when it's ethically possible.
We also provide an understanding of HOW the MCOs make those treatment decisions for substance abusing and chemically dependent individuals during the CARE MANAGEMENT or Utilization Review (UR) process - and how to ASK for 'WHAT' from the MCO's care manager.
Also, the module shows how to DOCUMENT both your assessment of need for treatment, and the treatment you deliver - in a way that reduces the chances that your paid claims will be 'RECOUPED' by the MCO. Some material is included from MiniCourses 1B and 1C, but this course does it from the AOD perspective.
Jump to the AOD Catalog
Click Here to Go Back to the Catalog for Course 5B - Managed Care Contract? Survive It!
Where The Rubber Meets The Road: The Nitty Gritty of How To Have More Gain and Less Pain With Those Managed Care Contracts!
Note: This is the same as Module 401 in FlexiCourse 10A, and it earns five (5) credit hours.
SUMMARY: MiniCourse 5B is an unvarnished, tell-it-like-it-is 'short course' on the PAINS AND THE GAINS that Managed Care holds in store for Mental Health and Chemical Dependency / Substance Abuse treatment providers. Negotiating for great options and needed changes in Provider Agreements, and contract designs that have 'Don't Even Think About It' written all over them. Problem solving with MCOs including how to collect on denied claims. When to say NO to an MCO, when to say YES, and when to say 'How about if I do THIS?' And Quality Management red flags to avoid.This is not just a tutorial on 'doing business' with a Managed Care Company. It presents the clinical conflicts and stresses that come with delivering care under a managed care model . . . and some viable clinical options that providers may seek to negotiate with an MCO, which can give the provider greater clinical autonomy in treatment decisions.
ABOUT OUR MANAGED CARE FLEXICOURSES
Interested in a course with MULTIPLE CERTIFICATES which you can claim (all or part) now or ANYTIME WITHIN THE NEXT 12 MONTHS, as you need them - with COST SAVINGS built in? How about 10 CREDIT HOURS for just $65.00 - with 4 certificates that you can collect whenever you need them, over the next year? See this one and MORE of our FLEXICOURSES, down below.
FLEXICOURSES! Our FlexiCourses contain from 2 to 4 'chapters' each, and each chapter grants a separate certificate. You SAVE MONEY when you purchase a FlexiCourse.
FlexiCourse 4A awards 4 CEU hours in two (2) certificates
FlexiCourse 5A awards 5 CEU hours in three (3) certificates
FlexiCourse 10A awards 10 CEU hours in four (4) certificates - just $40.00!
to the 'MULTI-CERTIFICATE COURSES' CATALOG
Our MANAGED CARE courses focus upon the oftentimes 'nerve-wracking' scenarios brought about by the 'Managed Health Care' scene - AND NOW the Health Care Reform Laws! These courses are designed to give you 'Quick and Easy Recipes for Managed Care Success' . . . or 1-2-3 directions on 'How To Survive It'. [GO DIRECTLY TO MANAGED CARE CATALOG]
Some of our topics we address include these:
- Managed Care requires a significant shift in treatment approach - with new approaches to programming and to documentation of the treatment you do. And you have to play 'Mother May I?' with the managed care company. Here's how.
- How to AVOID those 'duh!' PROVIDER ERRORS which can COST you big bucks in claims collection. How to COLLECT YOUR MONEY when the MCO or other insurance manager has erroneously DENIED YOUR CLAIM. What to be aware of, when working out CONTRACT details with a managed care company - as in 'the potholes' and the 'good stuff. When to say NO, when to say YES, and when to say 'How about if I do THIS?'
-The professional, organizational, and CLINICAL CHANGES required of treatment providers under a managed care contract - with additional detail on this subject beyond what's in our FlexiCourses.
- Understanding the issues and problems of RISK BASED CONTRACTING - and what IS the 'risk' that they keep talking about? And is the PROVIDER AT RISK, too - or is it just the Managed Care Company?
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GOALS OF MANAGED CARE COURSES DESCRIBED ON THIS PAGE .....
Below, we've summarized the goals of some of the Managed Care Courses described on this page, offering from 1 to 5 credit hours. (NOTE: For a description of our multi-certificate FlexiCourses, offering from 4 to 10 Credit Hours per course, go here.)
Goals for 1B
MiniCourse 1B - "Managed Care in Public Programs - It's Not Your Grandpa's Chevy!"
1 CREDIT HOUR - Goals for 1B
1. Intro to Goals and Objectives of Behavioral Health Managed Care - a.k.a. 'Why Are They Doing This To Us?'
2. Intro to clinical concerns & opportunities for professionals under a Managed Care plan
3. 'What Can Go WRONG' in a State's Managed Care plan, for the Managed Care Company AND for the provider.
Goals for 1C
MiniCourse 1C - "Understanding That MCO 'Capitation' Thing - and HOW It Impacts Providers!"
1 CREDIT HOUR -
1. Understanding The Impact Of This New Health Care Approach Upon Providers and Clients - It's Called 'Care Management'!
2. Review of Risk Based Contracts -- and How Providers Can Adjust Constructively.
3. Several Creative Service Delivery Approaches Which Promote Greater Autonomy In Programming For Mental Health And CD/SA Clients Providers.
Goals for 2B
MiniCourse 2B - "They're Coming to Audit WHEN?"
2 CREDIT HOURS - Goals for 2B
1. Understanding how the health care company or manager 'thinks' - e.g., what is 'medical necessity of treatment' at a PRACTICAL level . . . how and why they make those sometimes frustrating treatment decisions that may conflict with our clinical beliefs about what is needed for effective treatment to occur.
2. The four 'core concepts' used by managed care companies or other Care Managers when they audit your charts for compliance with Level of Care (LOC) criteria.
3. Five specific approaches to documentation which support good clinical records and positive audit outcomes.
4. Holes and gaps in charts - 12 specific categories of documentation issues which can result in audit failure (with examples!)
5. The goals of managed care - why are they doing this to us? and the implications of these goals for providers, both clinical and financial.
Goals for 2C
MiniCourse 2C - "We Have to Change WHAT?"
2 CREDIT HOURS - Goals for 2C
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.
3. How to think like a managed care company or Care Management Organization (it's essential for survival) - an overview of the Care Management (Utilization Management) process and their criteria for approval of treatment - including the four core concepts that drive those 'level of care' (LOC) decisions!
4. How the managed care company's RISK affects providers in their clinical operations -- the positives and the challenges, as well as specific examples of creative ways that we can serve our clients under a Managed Care contract - exciting options such as CASE RATES, and some 'front end services' contracts
5. Provider networks as a way to survive the shifts
6. Concerns of the National Alliance for the Mentally Ill (NAMI) about Quality of Care under a Managed Care plan. Includes the link to the '2006 NAMI 'Report On The States' - the states' report card
Goals for 3A
MiniCourse 3A - "Managed Care - Perils and Options for YOU!"
3 CREDIT HOURS - Goals for 3A1. Intro to goals and objectives of managed care - a.k.a. 'Why are they doing this to us?'
2. The Good, The Bad, And The Ugly of managed care plans, and how to adapt.
3. The nitty gritty of how providers are affected by this major shift in health care delivery - clinically and financially.
4. Understanding what to go after (and what to avoid!) when you contract with an HMO or other managed care company . . . what types of treatment fit with a managed care system - and how innovative, non-traditional services can be provided under the new managed care models for difficult high-risk clients.
5. The final lesson in this course focuses upon the clinical details of how Care Management departments make treatment decisions which impact your clients' recovery process, and how providers can accommodate to this shift in clinical emphasis.
MiniCourse 3B - "SA-CD, The Big Transition"
3 CREDIT HOURS - Goals for 3B
1. Understanding how working under an insurance contract or 'care management' system affects how we deliver treatment to chemical dependency clients. It's quite a change from our TRADITIONAL way of delivering treatment under state and federal addiction block grants!
2. The philosophical and practical shifts imposed upon our traditional addiction programming, brought about by managed systems of care.
3. Required shifts in the way treatment is documented.
4. Some workable and creative treatment options which addiction services providers can negotiate with MCOs and other health care insurers, which give the provider greater autonomy in treatment decisions.
Goals for 3C
MiniCourse 3C - "Beyond the Yellow Legal Pad - Biopsychosocial and Risk Assessment of Minors"
3 CREDIT HOURS - Goals for 3C
1. Learn the 5 primary ASSESSMENT ERRORS which auditors and legal representatives find in assessments of children and adolescents, which can cause the assessing professional grief in multiple ways.
2. Presenting two very different types of ‘child and adolescent assessments’: (1) a structured RISK ASSESSMENT for use in crisis situations involving potential-for-harm, which will provide good protection for you in an adverse legal situation, and (2) a structured, comprehensive BIOPSYCHOSOCIAL ASSESSMENT which covers the assessment ‘essentials’ INCLUDING a Mental Status Exam.
3. Understanding the reasons WHY it is unwise to 'wing it' when assessing minors - such as using an unstructured assessment approach and no standard assessment protocol.
Goals for 5B
MiniCourse 5B - "Managed Care Contract? Survive It!"
5 CREDIT HOURS - Goals for 5B
1. Contracting Issues that Affect How You Deliver Treatment, Who You Are Allowed to Treat, and What You Are Paid For It - including Provider Agreements that are fairly safe vs. those which have 'Don't even think about it!' written all over them.
2. Understanding 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.
3. The Four Core Concepts Used By The MCO When They Audit Your Treatment Records For Compliance With 'Level of Care' (LOC) Criteria - and how you can apply this knowledge to adjust what you write in treatment records.
4. What to do about erroneous CLAIMS DENIALS, and how to AVOID making the errors that cause providers to lose authorization to provide treatment.
5. How The MCO's RISK Affects Providers In Their Clinical Operations - the upside and the downside . . . as well as specific EXAMPLES of creative ways that we can serve our clients under a Managed Care Contract.
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