Course 2b - What Can Go Wrong In That Chart? A.K.A., 'They'Re Coming To Audit When?'

Course overview

This course is copyrighted and published by Marsha Naylor, MA, LPC, CEU By Net, Pendragon Associates LLC. The course earns 2.75 Clock Hours of credit for multiple State Boards including Florida, Texas, California, and Alabama, TCBAP-TAAP, IC&RC, NAADAC, and Florida Certification Board, and 2 PDHs for EACC. Also earns 1.75 NBCC Hours effective May 1, 2015 (taken prior to this date, it earns 2 NBCC Hours). Based upon these credentials, the course credits are accepted by most state boards for multiple licenses. You can VIEW the Study Guides and Quizzes for FREE on our website, in the Documentation Catalog. This is a PDF formatted slide show course which addresses the details of effective documentation in client records, within a Managed System of Care such as the ACA Health Plan contracts with both public and private providers. Want to pass that CLINICAL TREATMENT RECORD AUDIT? Want to avoid RECOUPMENT of claims payments already paid to you, when your records are audited? Want to avoid embarrassment and anxiety when the MCO calls for a client's record, or their auditors show up unannounced at your door? This course tells you how to succeed. This course clearly illustrates 12 problematic 'documentation syndromes' which will sabotage even the best and most experienced clinicians - including the 'POORLY DOCUMENTED LEVEL OF CARE¿ Syndrome, the ¿ZOMBIE CLIENT¿ Syndrome, the ¿PERPETUAL CARE¿ Syndrome, the ¿ANY-PATIENT ITP¿ Syndrome, the ¿FAILURE TO MODIFY¿ Syndrome, and several more. We tell you how to avoid those 12 deadly 'documentation syndromes' - no matter which type of assessment, counseling or treatment setting you're in, if you must demonstrate justification for treatment for which you have been paid. This self-paced slide show clearly describes 'what's DIFFERENT' about how we must DOCUMENT both ASSESSMENT and TREATMENT in mental health and AOD client records, compared to how we may have been trained, if we are working within a Health Care Reform contract. We give you useful and do-able tips on how to audit your own records - so that you are ready BEFORE the MCO, State auditor, or other contract manager arrives at your door or calls for a record (which is called a 'desk audit'). This valuable course also provides a clear explanation about HOW managed care contractors make pre- or post-authorization decisions to approve or deny your requests for treatment OR your submitted claims, based upon your assessment and documentation of the treatment your client needs. We are very clear about the nature of WHAT you must write in the client's record to support that authorization. GOALS of This Course: 1. Know the Goals and Issues Associated With the Conversion to Managed Care (Health Care Reform) 2. Be Aware of the Ethical Issues Which Health Care Reform Brings to Providers When Requesting Authorization, and When Delivering and Documenting Assessment, Treatment and Response to Treatment. 3. Understand How 'Care Management' Makes 'Medical Necessity' and 'Level of Care' Decisions About the Need for Treatment, and How This Meshes with Long-standing Ethical Requirements for Treatment Professionals 4. Know Specific Approaches to Documentation In Client Records Under a 'Care Managed' Contact, i.e., How to Avoid 12 Problematic 'Documentation Syndromes' Which Can Sabotage Even the Most Experienced Clinicians.