Question 1

__________________ is a nonprofit organization whose goal is to improve the quality of healthcare services.

Accepted Answer

A)   National Committee for Quality Assurance
B)   Joint Commission on Accreditation of Health care Organizations
C)   Health Care Finance Agency
D)   None of the above. B

Question 2

__________________ occurs when a practitioner assigns a more serious diagnosis than is warranted to obtain more authorized sessions.

Accepted Answer

A)   Downcoding
B)   Upcoding
C)   Treatment planning
D)   Integrity B

Question 3

Let's assume that you're a counselor in private practice and you receive third-party reimbursements through an MCO. You have been seeing a client who is working on existential issues resulting from the unexpected death of her child. The client exhibits symptoms of sadness, grief, and loss, but does not meet the criteria for an Axis I diagnosis. You have met with the client six times (the allotted amount of sessions that the MCO will reimburse), but you believe she could benefit from additional sessions. You could justify additional counseling sessions and continue to receive reimbursement from the MCO if you diagnosed the client with an Axis I diagnosis. Using Haas and Malouf's model of ethnical decision making, describe how you might handle this situation.

Accepted Answer

Answers will vary.
a. Haas & Malouf's Model of Ethical Decision Making
i. Gather information about the problem.
ii. Consult with colleagues and look at relevant literature to consider pertinent legal and ethical principles
iii. Create a list of appropriate responses
iv. Conduct a cost-benefit analysis of each potential response
v. Choose the option that best resolves the dilemma
vi. Act on that option and evaluate its effectiveness

Question 4

The process by which a managed care organization monitors the therapeutic process is called

Accepted Answer

A)   Capitation
B)   Utilization review
C)   carve-out
D)   gatekeeping

Question 5

A counselor whose client exhibits symptoms of borderline personality knows that she might struggle to receive reimbursement for this diagnosis due to its severity and persistence so she gives a mood disorder diagnosis instead. The behavior by the counselor would be considered

Accepted Answer

A)   Standard practice
B)   Rationing
C)   Capitation
D)   Downcoding

Question 6

Which of the following EAP services consists in EAPs responding to traumatic events that affect the workplace?

Accepted Answer

A)   Program implementation and management
B)   Training
C)   Critical incident management
D)   Workplace consultation

Question 7

__________________ designated federal funding for the development of managed care programs and required employer to offer managed care options to employees.

Accepted Answer

A)   The Health Maintenance Organization Act of 1973
B)   Wickline v. State of California
C)   Muse v. Charter Hospital of Winston-Salem, Inc.
D)   Joint Commission on Accreditation of Health care Organization

Question 8

__________________ is a coordinated set of professional activities focused on treatment planning and assurance of treatment delivery that addresses the client's needs while maintaining quality, cost-effective outcomes.

Accepted Answer

A)   capitation
B)   case management
C)   carve-out
D)   case rate

Question 9

_________________ is designed for people who are in executive management and involves a one-on-one helping relationship between the coach and the client.

Accepted Answer

A)   life coaching
B)   executive coaching
C)   health and wellness coaching
D)   career coaching

Question 10

Which of the following is a service provided to an organization by an EAP that includes skill building for supervisors, managers, and executive on topics such as conflict management, communication skills, and performance management?

Accepted Answer

A)   workplace consultation
B)   policy consultation
C)   training
D)   critical incident management

Question 11

______________, a relatively new discipline, is designed to help clients who are not in psychological distress and are able to use their strengths and resources to pursue goals, actions, and outcomes that enhance their lives, either personally or professionally.

Accepted Answer

A)   career counseling
B)   college/university counseling
C)   addictions counseling
D)   coaching

Question 12

Miller (1996) referred to time-limited treatments imposed by MCOs that result in early termination as

Accepted Answer

A)   capitation
B)   rationing
C)   gatekeeping
D)   cost efficiency

Question 13

All of the following, according to Shallcross (2011) are tips for building a successful private practice except

Accepted Answer

A)   Meeting regularly with a cohort of professional peers
B)   Keeping in contact with current and former clients through Facebook and/or Twitter
C)   Returning phone calls within 24 hours
D)   Taking a marketing or business class

Question 14

Which of the following is described as "a way of providing care, a philosophy of care, a way to finance care, and a way to control costs" (Talbott, 2001, p. 279)?

Accepted Answer

A)   SAMHSA
B)   Psychiatric Mental Health Nursing
C)   Managed care
D)   None of the above

Question 15

How have managed care systems impacted the counseling process?

Accepted Answer

The answer of How have managed care systems impacted the...

Question 16

Which of the following is the name of the coaching credential offered by the Center for Credentialing in Education (CCE)?

Accepted Answer

A)   Human Services - Board Certified Practitioner
B)   Licensed Professional Coach
C)   Board Certified Coach
D)   National Certified Counselor

Question 17

Which of the following is a form of payment in which the provider is paid on a per-member basis?

Accepted Answer

A)   carve-out
B)   case management
C)   capitation
D)   case rate

Question 18

In which of the following court cases was a service provider held liable for the HMO's decision to limit hospitalization, even though the provider had recommended additional treatment?

Accepted Answer

A)   Wickline v. State of California
B)   Muse v. Charter Hospital of Winston-Salem, Inc.
C)   Tarasoff v. University of California - Berkeley
D)   Bogust v. Iverson

Question 19

___________________ are reimbursements to EAP counselors provided by companies themselves.

Accepted Answer

A)   First-party payments
B)   Second-party payments
C)   Third-party payments
D)   Fourth-party payments

Question 20

As a clinical mental health counselor, how might you go about securing a placement on a provider panel?

Accepted Answer

The answer of As a clinical mental health counselor, how...

Exam 15: Employee Assistance Programs, Private Practice, Coaching and Managed Care