Clinical Component

Here is some insight into the day-to-day responsibilities of our LCSW providers.

Integrated BH Program (Primary Care BH Model) 
*Provider Title: Behavioral Health Consultant (BHC) 

  • Provides brief clinical interventions that focus on behavior change: Appointments with patients are 15-30 minutes. All referrals come from the medical clinics. Will get referrals for both mental health and medical concerns; again focus is behavior change. BHC can be interrupted when with a patient, just like a medical provider would be. 
  • The BHC schedule rotates every 30 minutes (30 minutes Warm Hand Off (WHO), 30 minutes scheduled follow up) 
  • We bill the HBAI codes for every encounter (96156, 96159, 96158) regardless of insurance or diagnosis. 
  • Provides services both in the clinic and is available via Telehealth for other clinics who do not have a BHC on site. 
  • We follow the Primary Care BH model focusing on behavior change and use of clinical skills for both medical and mental health diseases. Case management or needs for resources are referred to Care Management or Outreach and Enrollment (O&E). 
  • Full time BHC production goal is minimum of 60 Encounters a month with long term goal of establishing average of 150 encounters a month. Monthly incentive is based on number of patients seen every month. Incentive is paid quarterly. 
  • Schedules currently not blocked off for administration time. Monthly production has always met minimum goal but does not yet go over Level 3, meaning there is time open for documentation.  
  • Fully staffed program currently includes 3 BHCs (Twin, Burley & Jerome) providing telehealth BHC services to the smaller clinics. 
  • Long term goal is to have 4 BHCs. The fourth being responsible for telehealth BHC services focusing on the smaller rural clinics who cannot support a full time BHC in the clinic.


Specialty BH Program (in clinic) 
*Provider Title: Therapist 

  • Provides traditional therapy services: Expected to use translation services when patients do not speak English. We do not deny services based on language. Job description specifies age range therapist will be working with, this is based on community need. Important therapist feels comfortable with these age ranges, we will not be able to adjust depending on therapist desired populations or ages. For Medicaid children therapist is required to fill out a CANS (Child Assessment of Needs and Strength) every 90 days. Generalist clinic, we work with most conditions and mental health concerns. We do refer out for highly specialized areas of treatment (eating disorder, domestic violence programs, etc.). We do not provide substance use disorder treatment. Therapists may be able to provide group treatment but only if the office building has a room where this can be provided. Therapist must follow the group process for goals, documentation, etc. as outlined by BH Director. 
  • Schedule is set up for 60 minute blocks. Most appointments are 45 minutes, leaving 15 minutes between appointments for documentation, phone calls etc.  
  • Bill psychotherapy CPT codes (90791, 90832, 90834, 90837, etc) 
  • Offer in office, video-telehealth or phone-telehealth appointments. 
  • We have Outreach and Enrollment (O&E) workers and BH Care Coordinators who provide case management or Targeted Care Coordination when that is needed. BH Providers do not currently bill for case management or TCC because of the extra documentation that is required. Recommended they refer to the designated FHS staff for assistance in these areas to help therapist focus on clinical services. 
  • Schedules are blocked every week for the following: 1 hour administration time 1 hour (Wed, Thurs, or Fri) for a crisis, acute need appointment. 1 hour administration time to complete the CANS before reviewing with parents/child 
  • Once schedule is established we have a maximum of 4 CDA appointments in one week unless approved by the BH therapist. 
  • Program goal is to have at least 60% of time billable (5 patients a day or 24 patients a week) and 17% (or less) no show rate. Pay, employment, etc. is not dependent on this. Administration does follow up to see if there is anything we’re doing with scheduling, reminder calls, etc. when we see a lot of cancellations, no shows or no referrals.  
  • Incentives are based off our program production goals. This is determined on a daily basis for the number of patients seen that day; a small amount is applied if there are 5 or more patients seen in a day. Incentive is paid monthly. Mandatory and voluntary meetings do not work against you.  
  • Front Staff do the scheduling and monitor when annual CDA, 90 day CANS/Tx plan updates are due and when a discharge may have been missed. BH Therapist determines frequency of appointments that are clinically appropriate, when case needs to be discharged, etc.  
  • Most FHS medical clinics have a BH Therapist co-located in the clinic. The clinics that do not have a therapist currently do not have the office space to add one.   

School Based Specialty Program 
*Provider Title: School Based Therapist 

  • Considered to be part of our Specialty BH Program. 
  • FHS Therapist whose office is located at the school. Usually do not have after 5pm hours because you are following the school building hours. Referrals only come from the school to see students at that school. Do not provide services for someone who is not a student at the school.  Provides same services as therapists in our clinics however only sees students from the school that the therapist is located at. Follows FHS PTO, Holidays, etc. Will be providing services during summer and when school is on break. 
  • All billing codes, workflows, documentation requirements, expectations for services are the same as our Specialty BH clinics (described above). 
  • Incentive is the same as the Specialty BH clinic.  
  • Production goals are the same as the Specialty BH clinic. 
  • Times blocked off the schedule are the same with the addition of weekly 30 minute meeting with the school counselor(s)/principal. 
  • Mandatory and voluntary meetings are the same as Specialty BH clinic.  
  • Has more administrative duties where does own scheduling and doesn’t have Front Staff on site to help with those items like Specialty BH clinic does. Does have to follow the same processes and requirements for scheduling as the other clinics, just do not have the regular help to put the information in the system. 

Each program has the following program elements/meetings: 

  • Mandatory meetings: Monthly Program Provider meeting for the program you’re in. We discuss work flows, standards of care requirements, required documentation and clinical cases. Monthly meeting with BH Director. 
  • Peer Review Processes and Committee for each program. Being on a committee is usually voluntary but going to the meetings is mandatory. 
  • Voluntary Meetings: Leadership meeting with administration. Office “huddle” meetings (sometimes these are mandatory depends on clinic and when scheduled) 
  • Program Coordinator who is responsible for training new staff and who is an additional “go to” person when having questions about work processes, procedures or documentation. Supervisor is the BH Director. Program Coordinator is an extra support and training staff person. 
  • Each BH Provider is asked to work 2 hours each week after 5pm. Sometimes clinic hours require this to be changed like with the School Based Therapists. 
  • All schedules are set up to have 1 hour lunch unless BH Provider specifically requested to be different and changes are approved by BH Director. 
  • All BH Providers are expected to offer telehealth (phone or video) when appropriate. 
  • Each program has an incentive based on production.
  • Please Note: FHS does not guarantee an employee will receive the incentive. There are several factors impacting if the incentive applies for the month. This amount should not be calculated in your monthly salary as an expectation. The incentive is FHS’s way to acknowledge times when a provider has been busy, doesn’t have much down time.  

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