Managed Care
Healthcare reform, ACA, and managed care documentation.
Ethics of Treatment Documentation When Insurance Is Paying
Ethical dilemmas in managed care settings, documentation pressures from payors, medical necessity connections, creative service alternatives, and outcome review implications.
When Insurance Is Paying: The Ethics of Treatment Documentation
Documentation ethics under managed care constraints; what to write in treatment records; medical necessity and ethical requirements; payer scrutiny balancing confidentiality.
Intro to Behavioral Health Managed Care
Affordable Care Act overview; managed care impact on providers; documentation requirements; care management philosophy; updates on health care reform and clinical implications.
They're Coming to Audit WHEN? What Can Go Wrong In That Chart?
Effective client record documentation under managed care; 12 problematic documentation syndromes; level-of-care documentation; self-audit approaches; medical necessity justification; recoupment avoidance.
Introduction to Professional & Clinical Issues in Managed Care
Health care reform basic goals; care management impact; four core concepts driving level-of-care decisions; clinical examples; provider network approaches; access to treatment adaptations.
Managed Care: Is There Anything GOOD About It?
Managed care impact on providers and clients; care management decision-making; four core concepts driving level-of-care decisions; creative non-traditional service options; provider networks and step-down/step-up referrals.
The Big Transition: Managed Care, ACA, and Justifying Need for Treatment
Affordable Care Act and managed care impact on addiction treatment; vertical integration of care; documentation requirements for medical necessity; admission and discharge criteria; relapse and progress significance.
Capitation (Cost Containment) and You!
Affordable Care Act cost containment mechanisms; narrow networks and vertical integration; risk-based contracts; provider autonomy within cost containment frameworks; creative service delivery approaches.
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