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MC301 - Quiz 2

 

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1)
Which was NOT mentioned as an issue for professionals who work within a managed care system?
 
The Core Concepts that shape how we need to document treatment under Managed Care
Understanding how HMOs 'think'
Ways to circumvent Federal Medicaid 'Level of Care' criteria whenever appropriate and feasibile.
The HMO's Level of Care Criteria
 
2)
Under managed care, _________________ think 'clinical' and 'treatment' and 'dysfunction' when we document the client's need for services.
 
it is unnecessary to
we should avoid a tendency to
it is essential that we
 
3)
By law, diagnosis takes precedence over functionality, when the HMO determines Level of Care.
 
True False
 
4)
We may use our clinical and professional judgement as to WHICH specific treatment we provide to the client, once we have an authorization for a certain number of hours of treatment
 
True False
 
5)
Failing to benefit from treatment cannot be an issue under managed care because of Federal anti-discrimination statutes.
 
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 extend his treatment indefinitely.
 
True False
 
7)
The MEDICAL NECESSITY of CONTINUED treatment at a certain LEVEL OF CARE must be supported in the client's treatment record through several things, including but not limited to . . .
 
Documentation of his current level of functioning
Documentation of his response to the treatment thus far
Documentation that we have addressed his diagnoses
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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