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Capital Area Evaluators Level Of Care Meeting

Capital Area Evaluators Level Of Care Meeting. February 6 ,2008: 9A-12Noon & February 11, 2008: 1PM-4PM . Presenters. Katie Bugbee, QI Psychologist Reviewer Roger Beardmore, Clinical Psychologist Reviewer Mollie Seifert, Provider Relations Rep DJ Dunlap, QI Program Project Manager

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Capital Area Evaluators Level Of Care Meeting

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  1. Capital Area EvaluatorsLevel Of Care Meeting February 6 ,2008: 9A-12Noon & February 11, 2008: 1PM-4PM

  2. Presenters • Katie Bugbee, QI Psychologist Reviewer • Roger Beardmore, Clinical Psychologist Reviewer • Mollie Seifert, Provider Relations Rep • DJ Dunlap, QI Program Project Manager • Deb DeVivo, Supervisor of Clinical Support and Processing • Keven Cable, Provider Relations Trainer and Quality Reviewer

  3. Agenda • QI Updates • Clinical Updates • Provider Updates

  4. QI Updates • Review Requirements for Supervision • New QI Program Manager: Bonnie Clark, R.N., M.ED.

  5. Clinical Updates • Flow Charts for BHRS, RTF & FBMHS • Time Frame for Evaluation Submission • Process of Provider Choice • Provider of Choice needs Correct Demographics • Specialized Evaluators & ISPT meetings • Addendums Vs. Clarifying Statements • Expectations for Addendums • Time Frames for STAP

  6. Clinical Updates • Evaluation Content • Sources of information • Clarity of symptom descriptions • Presence of Substance Abuse Assessments • Accuracy of authorization periods • Use of professional language • Timeliness of information • Clarityregarding member’s treatment response • Inclusion of objective measures • Presence of clear rationale for services • Use of “Discussion” section of evaluation • Need for school input • Levels of Care • Autistic Spectrum Disorders

  7. Provider Relation Updates • Provider Data Update • Attestation Forms

  8. Discussion

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