{ "item_title" : "The Collaborative Care Program Implementation and Billing Integrity Manual", "item_author" : [" Claire Alderton "], "item_description" : "Turn Collaborative Care Work Into Reconstructable Monthly Claims A collaborative care billing guide should do more than list codes. It should show you how consent, registry activity, qualifying time, psychiatric consultation, payer rules, and pre-bill review connect for each patient-month. This manual gives primary care and integrated behavioral health teams a practical operating system for that work. Good Care Can Still Produce a Weak Claim You may already have a registry. Your program may be small. Your staff may document carefully. Yet a claim can still fail when evidence sits across an EHR, spreadsheet, time log, consultant note, and billing platform. One missing link can turn valid clinical work into a denial, repayment question, or month your team cannot defend. Follow One Program From Launch Through Its First Audit Bellwood Family Health, a fictional multi-site practice, carries the full manual. You see its governance structure, consent workflow, registry, measurement process, psychiatric consultant cadence, time records, payer matrix, monthly close, and evidence binder take shape in sequence. Documentation gaps are planted early, found by later controls, corrected through dated addenda, and traced to process changes. Build the Seven Controls That Hold the System Together - Define ownership, coverage, consent, enrollment, and disenrollment.- Design registry fields that trace activity to a billed month.- Set BHCM documentation and measurement-based care standards.- Record substantive psychiatric review, routing, and provider response.- Separate qualifying time from scheduling and program administration.- Reconcile minutes, detect duplication, and attest monthly totals.- Run payer checks, code sign-offs, pre-bill holds, and audit assembly. Use Tools Built for Daily Work, Not Shelf Reading Across 15 sequential chapters, you work with completed examples and reusable templates: program charters, enrollment logs, field dictionaries, missing-data reports, recommendation-routing logs, time worksheets, duplicate checks, code-decision sheets, payer trackers, exception queues, correction records, root-cause dashboards, and claim-to-evidence crosswalks. Appendix A collects fillable versions. Appendix B supplies quick-reference tables and decision flows. See What Strong and Deficient Files Actually Look Like The manual includes compliant patient-month files, a deficient case file, short and nonbillable months, duplicate-time corrections, missing authorization evidence, delayed consultant responses, and corrective-action plans. Each example shows what the control should catch, who owns the response, and what record remains afterward. Payer and code rules are treated as dated facts to verify, not permanent answers. Already Have a Registry, Limited Staff, or Changing Payer Rules? A registry stores data; it does not define fields, ownership, standards, or release controls. Small programs still need the same links, applied to fewer patients. Changing rules are handled through source, effective-date, verification-date, owner, and status fields, plus scheduled revalidation. You can build the system one control at a time without pretending every rule will stay fixed. Start With the Control Most Likely to Fail Under Review Open the manual, identify where your current evidence is scattered, and compare your process with the implementation checklists. Your first session can produce a named sponsor, a documentation map, and a clear list of gaps to address. Build the operating system now, before a payer request forces your team to assemble one under pressure. Move from scattered records to a monthly process your team can repeat, inspect, correct, and defend, month by month.", "item_img_path" : "https://covers2.booksamillion.com/covers/bam/9/79/818/769/9798187698837_b.jpg", "price_data" : { "retail_price" : "199.99", "online_price" : "199.99", "our_price" : "199.99", "club_price" : "199.99", "savings_pct" : "0", "savings_amt" : "0.00", "club_savings_pct" : "0", "club_savings_amt" : "0.00", "discount_pct" : "10", "store_price" : "" } }

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