Product Details
- Format:
- Digital Seminar
- Details:
- Downloadable/Streaming MP4 Video and MP3 Audio with electronic manual and instructions.
- Publisher:
- PESI Inc.
- Copyright:
- 2/5/2021
- CE Available:
- No, CE credit is not available
- Product Code:
- POS055315
Objectives
- Determine the importance of proper documentation in informing clinical decision-making.
- Evaluate the role of the clinical diagnosis in justifying medical necessity and providing more effective services to clients.
- Determine how to use the behavioral language required by insurance companies to facilitate delivery of services to clients.
- Explain how to document what really happens in a clinical session without violating privacy or confidentiality.
- Assess medical necessity by employing the “golden thread” for improved treatment outcomes.
- Analyze potential red flags in documentation and the proper corrective measures for them
Outline
Get Past Your Negative Feelings About Documentation
- Documentation as a contributor to good clinical work
- Documentation through the lens of the “Golden Thread”
- Documentation as a protector of income and integrity
- Anxiety-reducing answers to common questions
Embrace the Requirement of Medical Necessity
- The elements of medical necessity
- The “Golden Thread” as a key part of medical necessity
- Establish the connection between diagnosis and treatment
How to Write:
- The Diagnostic Summary
- What’s needed in the diagnostic summary, and why
- How the diagnostic summary initiates the path of the Golden Thread
- The Treatment Plan
- What’s needed in a treatment plan, and why
- Operationalize the presenting problem
- Questions to ask
- Describe the diagnostic criteria in behavioral terms
- Make a clear connection between goals, objectives, and interventions
- Protect the client and the therapist with a thoughtful risk assessment
- Evaluate client progress
- How the treatment plan it continues the path of the Golden Thread
- And more …
- Activity: Write a treatment plan
- The Session Note
- The session’s note relationship to the treatment plan
- What’s needed in a session note and why
- Descriptive or narrative approach to interventions used
- Changes to treatment plan
- Justify multiple sessions
- Activity: Write a session note
- The Case and Collateral Contact Note
- What’s needed in a case and collateral contact note and why
- Differences between case and collateral contact notes
- Provide a clinical justification for the case/collateral consult
- The Discharge Summary
- What’s needed in a discharge summary, and why
- How the discharge summary completes the Golden Thread
20 DOCUMENTATION RED FLAGS THAT LEAD TO TROUBLE
Continuing Education Credits
CE Credit is not available for this product.
Audience
- Mental Health Administrators
- Marriage and Family Therapists
- Psychiatrists
- Psychologists
- Counselors
- Social Workers
- Office Managers
- Mental Health Nurses
- Addiction Counselors
- Other Mental Health Professionals
Satisfaction Guarantee
Your satisfaction is our goal and our guarantee. Concerns should be addressed to PESI, P.O. Box 1000, Eau Claire, WI 54702-1000 or call (800) 844-8260.
ADA Needs
We would be happy to accommodate your ADA needs; please call our Customer Service Department for more information at (800) 844-8260.