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Practice Management Insight |
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November 2011 |
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A report on events affecting Oklahoma providers |
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October 19-November 15 Justice and Mental Heath Collaboration Training Tulsa November 1-2 2M2L Training Tulsa, OK November 3– 4 SOC Wraparound 101 Tulsa, OK November 4 Living Choice Advisory Committee Meeting Oklahoma City November 4 Managing the Pathological Gambler in Recovery Oklahoma City November 7- 8 Case Management Training Oklahoma City November 7 SOC FPS Training Tulsa, OK November 8 –9 Combined ASAM & ASI Training Tulsa, OK November 8 SOC FSP Training Oklahoma City November 9 Drug Utilization Review Board Meeting November 10 OHCA Board Meeting November 11 2nd Campus Wellness Symposium Oklahoma City November 11 Veterans Day October 14-18 Substance Abuse Prevention Specialist Training Oklahoma City November 15– 16 2M2 Training Vinita, OK November 15 Perinatal Task Force Meeting Oklahoma City November 16 Ethical and Cultural Competency Lawton, OK November 16 Statewide Serving Adults With MS & SA McAlester, OK November 16 DMEPOS Advisory Council OHCA Oklahoma City November 16 Medical Advisory Committee Meeting OHCA Oklahoma City November 16 Mindless for Clinical Intervention & Self–Care Tulsa, OK November 16 Ethical Dilemma Oklahoma City November 17 - 18 SOAR Training Oklahoma City November 28-29 Combined ASAM & ASI Training Oklahoma City November 28-December 2 RSS Training Tulsa, OK November 24 Thanksgiving Day November 30– December 1 T- ASI Teen Addiction Severity Index Oklahoma City |
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Women who experiences gender-based violence (GBV), including rape, sexual assault, and stalking, have a higher associated lifetime ratio of mental health disorders according to a recent article published in JAMA. The article emphasized that violence against women is a major public health concern which contributes to high levels of illness and death. In the United States, 17% of women report rate or attempted rate. According to the study, there is evidence that gender-based violence is connected to mental disorder among women. .Dr. Susan Rees, University of New South Wales, conducting research to assess lifetime prevalence of mental disorders found that 27.4% of the women in her study confessed to having experienced at least 1 type of gender-based violence. |
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Gender-Based Violence Linked to Mental Health Disorders in Women |
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It was also revealed that women who had experience exposure to 3 or 4 types of GBV had higher rates of lifetime mood disorders and substance use disorders. Suicide attempts for women exposed to GBV increased to a range of 6.6% to 34.7%. |
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OrionNet Systems would like to wish you and your family a safe and fun holiday. Happy Thanksgiving. |
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November is … American Diabetes Month Lung Cancer Awareness Month National Family Caregivers Month National Stomach Cancer Awareness Month Lung Cancer Awareness Month COPD Awareness Month Get Smart About Antibiotics |
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UNDERSTANDING BORDERLINE PERSONALITY DISORDER |
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“Borderline personality disorder (BPD) may not be as well-known as schizophrenia or bipolar disorder, but it is more common affecting an estimated two percent of adults. BPD is a mental condition that causes emotional stress and negative behaviors. Sufferers of BPD have a distorted or confused sense of self. These individuals exhibit low self-esteem and self-loathing. Often, the sufferer will feel misunderstood or mistreated and retaliate on those around them. The unpredictable and erratic behavior is defined by frequent job changes and relationships. Depression or bipolar disorder will cause an individual to experience the same mood for several weeks, however, BPD created intense bouts of anger or near-suicidal depression that can last an hour or a day. BPD is credited wit approximately “10 percent of patients in psychiatric care and 20 percent of those who have to be hospitalized,” according to a 2008 article in Scientific America. Warning signs to watch for in borderline personality disorder include: Impulsive and risky behavior, such as risky driving, unsafe sex, or illegal drug use Strong emotions that wax and wane frequently Intense but short episodes of anxiety or depression Inappropriate anger, sometimes escalating into physical confrontations Difficulty controlling emotions or impulses Suicidal behavior Fear of being alone. Researchers are not completely sure as to the cause of BPD, but the Mayo Clinic has outlined factors which may play a role in BPD. Among those factors are genetics, environmental factors such as abuse, and brain abnormalities. The treatment for BPD includes psychotherapy and medications that aid in the control of associated problems such as anxiety or depression. To learn more about BPD, visit the National Institute of Mental Health website. |
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Medicaid Payments Not Reaching Mental Healthcare Providers In turn, patients are going without treatment. A lot of these people are directly from hospitalization and need to be seen up to twice a week to maintain their mental health to not return to the hospital," said Bryant. The Oklahoma Health Care Authority manages the Medicaid program. It is aware of the problem but blames a company it hired. OptumHealth was awarded a contract to handle behavioral health reimbursements for the state. Carter Kimble, OHCA Public Affairs Information Representative, said the company was given one month to have its system up and running by October 1st. That didn't happen. The system is still not completely functional, but Kimble said the OHCA has created a stop gap so providers could keep their doors open. It has taken providers claims for the past three months and averaged it out to a payment for October. Kimble said, "Our responsibility is to make sure the contract issue gets resolved but in the meantime to have some sort of ability to help those people have services." OptumHealth released the following statement: OptumHealth is committed to supporting our providers and is working quickly to fix the problem caused by software issues. Providers having problems using the electronic system can fax their requests to OptumHealth to receive a prior authorization at 855-543-5921. This will allow the Oklahoma Health Care Authority to pay providers accurately and in a timely manner. Any provider that needs help with a prior authorization submission can call us at 800-854-0833. |
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Medicaid Payments Not Reaching Mental Healthcare Providers |
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“Therapists in our state are going out of business or are being forced to turn away patients with depression or other mental health issues. Jennifer Bryant manages a group of therapists and says many of them have not received Medicaid reimbursements. |
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How did the state miss problems with Optum? |
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Before handing over its sprawling behavioral health system to Optum Health this July, the state wanted to know whether the company would be able to process the thousands of invoices and claims submitted every month. So it looked at Optum’s claims management system and declared it was good to go. But as soon as Optum took over, its claims management system failed under the crush of real-world use. Hundreds of nonprofits and small businesses found themselves cash-strapped as they went unpaid, sometimes for months, as their claims remain unprocessed by Optum’s system. Optum touted its system in its initial proposal as an improvement on how to assess and pay thousands of invoices and claims for services for New Mexico’s mentally ill and those struggling with substance abuse. So how did a state review fail to detect the potential for such big problems prior to Optum’s takeover? Not surprisingly, the firm and the state have competing versions. “We believed the system worked, the [Behavioral Health Collaborative] believed the system worked,” Sandy Forquer, president of Optum Health New Mexico, said last month, referring to the state’s review of its system. “The problems that emerged were ones we did not expect, the state did not expect.” The state, however, says its review identified some issues that Optum agreed to correct, but apparently did not. “We indicated that there were some issues and Optum said they would correct them,” said Betina Gonzales-McCracken, a spokeswoman for the New Mexico Behavioral Health Collaborative. McCracken acknowledged that the volume of invoices and claims that flooded the system once it went live July 1 were much greater than the test sample of claims the state used to conduct its readiness review. That increased volume “magnified the problems that were identified,” she said. The state has since levied a sizable penalty — more than $1 million — on Optum, a fine the firm is disputing. |
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