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PerformCare Presentations

PerformCare offers the following presentations to all our network providers. These presentations are intended to illustrate a variety of behavioral health topics and to simplify and explain PerformCare's processes and requirements.

Training topics:

Compliance and special investigation unit

Fraud, waste, and abuse

March 2015

This training covers:

  • What is fraud and abuse?
  • What are the different types?
  • How to detect fraud and abuse.
  • Laws, sanctions, and penalties for violations.

Documents

If you have questions about this training, email Keven Cable. He will forward your query to PerformCare's compliance officer.

General compliance overview

This training covers:

  • Defining fraud, waste, and abuse (FWA).
  • An overview of Pennsylvania and federal compliance laws.
  • Your role as a provider in identifying and reporting fraud and abuse.
  • Examples of Medicaid fraud and abuse.
  • The role of the Special Investigations Unit (SIU).
  • Preventing, detecting, and reporting fraud and abuse.
  • Elements of an effective compliance program.
  • Health Insurance Portability and Accountability Act (HIPAA) and other privacy laws.

Documents

Medical record documentation

This training covers:

  • Provider documentation overview. 
  • Medical records.
  • Requirements. 
  • Common issues. 
  • Treatment plans and progress notes.
  • Encounter forms.
  • Resources.

Documents

Provider profiling

Provider profiling training

February 2019

This training covers:

  • The purpose of provider profiling.
  • Improvements made to provider profiling.
  • Provider profiling reports to be distributed.
  • The distribution review of provider profiling reports.
  • Plans for provider profiling.

Documents

Behavioral health rehabilitation services (BHRS)

February 2019

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Community-based mental health services (CBMHS)

February 2019

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Family-based mental health services (FBMHS)

February 2019

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Mental health inpatient services (MHIP)

February 2019

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Mental health outpatient services (MHOP)

February 2019

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Mental health partial hospitalization program (MH-PHP)

February 2019

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Substance use (SU) services (inpatient/residential)

February 2019

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Substance use outpatient and partial hospitalization services

February 2019

This training covers:

  • The purpose of provider profiling.
  • A review of the improvements made to provider profiling reports.
  • An overview of the SU outpatient and partial hospitalization services provider profiling report.

Documents

Treatment record reviews (TRR)

BHRS treatment plan

This training covers:

  • How to write goals and objectives
  • How to document progress
  • How to address discharge planning
  • Crisis/safety planning

Documents

Crisis planning for all levels of care

March 8, 2017 | 27:01 minutes

This training covers:

  • A general overview of crisis plans components as part of a standard TRR.
  • A review of crisis planning audit tool indicators.
  • A review of each indicator.

Documents

QI plans training

March 2015 | 59:22 minutes

This training is only for Capital Area BHRS providers.

This training covers:

  • The philosophy behind continuous QI plans
  • Explains: Plan, do, check, act, cycle
  • How to write a BHRS QIP
  • Final slide (#38) answers questions that were raised in the training

Documents

Relapse prevention planning

March 8, 2017 | 20:45 minutes

This training covers:

  • A general overview of relapse prevention plan components and criteria as part of a standard TRR.
  • A review of relapse prevention planning audit tool indicators.

Documents

QI trainings

Administrative and treatment quality concerns

This training covers:

  • The reason for changes to the performance monitoring (from provider performance to administrative and treatment quality concerns).
  • The administrative and treatment quality concern indicators.
  • How and when providers will receive administrative and treatment quality concerns reports.
  • The expectations for follow up, if needed.

Documents

Claim submission overview

September 2016 | 30:33 minutes

This training covers:

  • Timely filing of claims.
  • Required fields on the CMS-1500 form.
  • Required fields on the UB-04 form.
  • Corrected claims submissions.

Documents

Clinical practice guidelines

February 2015 | 16:07 minutes

This training covers:

  • The purpose of clinical practice guidelines
  • How to use clinical practice guidelines
  • How to find clinical practice guidelines on the PerformCare website
  • The Provider Advisory Committee and the adoption of clinical practice guidelines

Documents

Evaluator quality monitoring program: Assessment of best practice evaluations (BPE)

September 2015 | 59:43 minutes

The training covers:

  • The background to this particular quality monitoring program.
  • The evaluator orientation process.
  • Introduction of QI-040 and the new quality monitoring process.
  • Identify quality improvement expectations associated with the new process.
  • Provide item specific training on the Provider performance measurement table.

Documents

Member satisfaction survey results webinar

November 2018 | 23:48 minutes

This training covers:

  • The purpose of the member satisfaction survey.
  • An overview of the survey design, data collection, and content.
  • A review of the 2018 results.
  • An overview of plans for the 2019 member satisfaction survey.

Documents