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Course 2C - Quiz 2

 

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1)
Which was NOT listed as one of the Core Concepts which guide Managed Care companies in their treatment authorization decisions?
 
Medical Necessity – needed to improve, maintain, or prevent deterioration
The credentialing status of the immediate provider - needed to ascertain competence to carry out the treatment
Current Functionality – Diagnosis is not enough
Treatment Goals & Interventions – Do they match the diagnosis, functionality and service descriptions?
Progress – Responding to treatment, likely to benefit with more?
 
2)
Under managed care, _________________ think 'clinical' and 'treatment' and 'dysfunction' when we document in a client's treatment record.
 
it is legally inadvisable to
we should avoid a tendency to
it is essential that we
 
3)
By Federal law, diagnosis takes precedence over functionality, when the HMO determines Level of Care.
 
True False
 
4)
If the client has two major MH or CD diagnoses, we do not need to address both in our treatment plan and treatment documentation. We should select the diagnosis which we consider to be the most pressing.
 
True False
 
5)
Federal anti-discrimination and disability statutes prohibit denying care because of failure to benefit from treatment.
 
True False
 
6)
For persons with Chemical Dependency, if the individual has had multiple relapses to use of alcohol and drugs despite treatment, the HMO will typically extend his treatment until the desired outcome is achieved.
 
True False
 
7)
The MEDICAL NECESSITY of continued treatment at a certain LEVEL OF CARE must be supported by these notations in the client's treatment record (check one):
 
Documentation of his current level of functioning
Documentation of his progress and response to the treatment
Documentation that we are addressing each of the major diagnoses, in the treatment process
All of the above
None of the above if he has a diagnosis of schizophrenia
 
8)
Managed Care is based upon DISEASE MANAGEMENT - a 'medical model' of how to deliver treatment to individuals with a mental health or substance abuse or chemical dependency diagnosis.
 
True False
 

 

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