• COURSE DESCRIPTION

    This presentation will inform listeners about the basics of working in a Managed Care Environment. Listeners will learn information about managed care policies to help them develop protocols and processes to thrive in an insurance payer system of care; the ethical and legal consequences of inadequate insurance protocols will be highlighted. Providers will learn an 'insider perspective' about how to navigate the insurance system efficiently and effectively, in terms of issues like rate negotiations and the utilization of specific billing codes.

  • LEARNING OBJECTIVES

    Upon completing this course, participants will be able to: Describe how providers become empaneled (a participating provider) with insurance companies; Describe one or more legal and ethical consequences of using incorrect billing codes


    TARGET AUDIENCE & INSTRUCTIONAL LEVEL

    This course is intended for psychologists, therapists, social workers, clinical counselors, and addiction counselors. Instructional level: Intermediate





  • HOW TO TAKE THIS COURSE

    In order to receive a certificate of completion reflecting the associated CE credit hour, you must:
    #1: Have an active paid Clearly Clinical membership
    #2: Listen to the corresponding course podcast
    #3: Achieve a passing grade on the post-presentation test (the test has up to ten questions and you must earn a score of at least 80%; users can re-test up to three times. After three attempts, users are advised to re-listen to the audio course in its entirety and then subsequently re-test. Psychologists who are seeking CE credit may not be awarded credit if they attempt to pass the post-test more than three times.)
    #4: Complete the requested course evaluation.

    Course elements (including the course audio, post-test, and requested course evaluation) can be completed on a computer or mobile device via your Clearly Clinical account.

  • COURSE FORMAT

    This course contains a one-hour, non-interactive audio podcast which is available for free on all major public podcast platforms, including YouTube, by searching for 'Clearly Clinical'. You can also listen to and download the audio file via our course player.

  • ACCOMMODATIONS

    If you have special needs or need an accommodation, please email us at [email protected] and we will do our best to assist you.

    If reading along while listening is helpful for you, we recommend listening to our podcast on YouTube with the closed captioning feature enabled (to do this, click the button in the YouTube video player with the 'CC' on it).

  • CERTIFICATE ACCESS DETAILS

    Once you've completed the course, your certificate will automatically populate in the 'Certificate' section of your account; it will also be emailed to you. Course certificates will be on file for ten (10) years from date of course completion regardless of a user's paid membership status.

  • COMMERCIAL SUPPORT

    There is no known commercial support or conflict of interest for this CE program, presenter, sponsor, instructor, or content. The instructor references their own resources as a potential option for further learning.

Interviewer and Interviewee

David Nefussy

Senior Instructor

David Nefussy is Spectrum Health’s Vice President of Business Development. He previously served as the regional director of provider network services for MA, ME, NH, RI and VT at OPTUM Health, otherwise known as United Behavioral Health (UBH) where he was responsible for contracting and provider relations. Prior to UBH, he worked in a similar capacity for PacifiCare, Magellan, Beacon Health Strategies, Harvard Pilgrim Health Care and Private Health Care Systems. In addition, he's worked with several committees around behavioral health/primary care integration, 2013 CPT Code changes and federal mental health parity, including the Massachusetts Association of Health Plans, Massachusetts Division of Insurance, Association of Behavioral Health and Massachusetts Association of Behavioral Health Systems.

Elizabeth 'Beth' Irias, MS, LMFT

Interviewer & Clearly Clinical Founder

Elizabeth 'Beth' Irias (she/her) is a licensed Marriage & Family Therapist and the Founder and President of Clearly Clinical. She has specializations in Clinical Documentation, Feedback Informed Treatment, Best Practice, and Utilization Review, and works closely with clinical teams across the US as a trainer and national conference presenter; Beth was formerly an adjunct professor at Pepperdine University in the Graduate Psychology and Education department. Licensed in California and Oregon, she provides therapy via her private practice to young adult and adult clients, members of the LGBTQ population, and those with addictive disorders. She has two young children, a super cool spouse who helps out with Clearly Clinical's tech, and a rescue dog.

Why is Clearly Clinical the nation's premier CE provider?

  • CONVENIENT: All courses are 1-hour podcast episodes, available on YouTube, Apple Podcasts, GooglePlay, and all other free public podcast platforms

  • AFFORDABLE: We offer quality CE courses through a reasonably-priced membership

  • SOCIALLY-RESPONSIBLE: We make ongoing donations to The Trevor Project for LGBT youth suicide prevention, and have also previously donated to Black & Brown Founders, the NAACP’s Legal Defense Fund, Black Women’s Blueprint, Feeding America, and The Center for Reproductive Rights.

  • WOMAN-OWNED & QUEER-OWNED: We are founded and run by Elizabeth Irias, LMFT

  • DIVERSE: We highlight expert presenters from historically-marginalized communities


Quick Note: Are you confused about the difference between a Continuing Education Unit (CEU) and a Continuing Education (CE) Credit Hour?  Visit our Frequently Asked Questions page for clarification!