Mental Health Industry Knowledge

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Across
  1. 1. Insurance carriers that manage and define client health insurance benefits (e.g. Aetna, Optum, BCBS, Cigna).
  2. 3. Type of therapy that is solution-focused, goal-oriented, short-term. Client-provider relationship is centered on tangible outcomes, like learning new skills, with both parties taking an active role in achieving the therapeutic goal.
  3. 5. A predetermined dollar amount that patients owe per medical visit, regardless of the actual contracted rate (or cost) of the visit.
  4. 7. Abbreviation for a type of visit that Alma clinicians do not provide through Alma’s insurance program. This definition is to help clarify the acronym so we know not to use this benefit if we see it.
  5. 10. A process that health insurance companies utilize to review how necessary a certain care plan may be in treating your medical condition prior to covering the cost of that visit. Alma has already negotiated with our contracted payers that no prior authorization is needed for therapy sessions 60 minutes or less. Prior authorizations are required for psych testing.
  6. 12. a non-invasive, mind-body treatment in which patients learn to control involuntary bodily processes (muscle tension, blood pressure, heart rate)
  7. 13. Abbreviation for Licensed Mental Health Counselor
  8. 14. Your payment responsibility to your insurance payer. Certain benefits may be subject to you meeting your individual (or family!) deductible before the insurance plan will cover any portion of the visit costs
  9. 16. Abbreviation for explanation of benefits
Down
  1. 2. The provider facing version of an EOB. Basically, this is a document than an insurance sends a provider explaining what they paid for different charges and why. Often, it also explains why they denied or paid less on a claim than a provider might have expected.
  2. 4. Abbreviation for Licensed Clinical Social Worker
  3. 6. A licensed clinician that provides patients with health care services.
  4. 8. Services provided to a patient without the patient being admitted to the hospital.
  5. 9. A code that providers use to indicate what happened during an appointment.
  6. 11. Abbreviation for Licensed Marriage & Family Counselor
  7. 14. Abbreviations for extensive, highly structured form of CBT; often used for severe behavioral issues or higher-risk clients.
  8. 15. Abbreviation for Licensed Professional Counselor