800.456.6327 Insurance Pros & Brokers Providers & Affiliates INDIVIDUAL & FAMILY LOGIN Providers & Affiliates Affiliate Guidelines Thank you for working with us as a Perspectives clinical affiliate. We strive to get people the help they need with the first call, and our affiliate clinicians are vital team members in this effort. This guide is offered to help you work together with us in providing quality EAP services to the employees and family members of our customer organizations throughout the world. You may download the guidelines here. First Appointment Date/Time One of the benchmarks of our service to our client companies is that the affiliate calls the client within 24 hours, and offers an appointment within three working days. We ask the affiliate to call the client and to leave us the appointment date and time, as a way to provide better service to the client and simplify access for them. However, this means that we need the help of our affiliates in documenting and communicating to us when there is a problem scheduling a client. If the client does not return several phone calls, we need to know this as soon as possible. We also need to know if the client cancels or fails the first appointment. You can leave all of this information in our 24-hour affiliate callback voice mail at (800) 558-7014. If any problems or issues arise about the referral, for example, if the client does not accept any of your available appointment times and/or the wait would be too long, please contact the Access Center counselor who referred the client to you, at (800) 456-6327. Work/Life Issues and Workplace Focus We encourage you to keep work/life issues (such as balancing work and family, managing difficult relationships at work, legal issues, financial issues, and child/elder care issues) in mind when seeing our clients. One of the things that distinguish Perspectives from some other organizations that use independent providers for EAP services is that our services are workplace oriented, and are focused on helping employees to be more effective and productive. You have two clients when working with us – the individual (or family) and the client company. Referring clients to local resources (such as Consumer Credit Counseling agencies, child care referral services, and area agencies on aging) is one of the ways we can be of help to our clients and their employers. Some of our client companies have work/life referral services as part of their EAP service, but for the others, the EAP counselor can still be of assistance by providing information and local referrals for these services. Feel free to ask an Access Center counselor if the client’s company has the work/life package. If so, you can direct the client back to the Access Center for a telephone transfer. If job-related issues come up in sessions, keep in mind that we have two customers: the employee and the company. For that reason we adopt a problem-solving approach about job-related problems, and avoid taking sides or offering to advocate for the employee against others at the organization. We never offer to support an employee’s request for time off, instead directing them back to their supervisor or HR department. Confidentiality Issues and Notice of Privacy Practices Perspectives does not require the client to sign our Notice of Privacy Practices. We offer it to the client when we open the case in our Access Center. We let the client know that the notice is available from the counselor, or on our website (https://www.perspectivesltd.com/privacy-policy/). You do not need a release of information form for Perspectives when you are seeing one of our EAP clients. Under HIPAA and state mental health confidentiality laws, you are acting as a business associate and thus as part of Perspectives when seeing one of our clients. (If you happen to be seeing one of our managed care clients as a provider, you are considered an independent clinician and should have a release signed for case management reviews.) If you are making a referral, we ask that you obtain a release to speak to the provider when giving clinical information. Perspectives Online Perspectives now has a website available to employees and families of all our client companies. The revamped website has a great deal of useful information including links to legal referrals for criminal law, divorce, child custody, and wills/estates. The website also includes financial resources for budgeting, debt management, bankruptcy, and taxes. There are articles on work/life balance and mental health issues. There are also resources for child care, elder care, health/fitness, and educational services. Skill Builders are available on a variety of topics such as managing stress, effective communication, and time management. There are also Webinars available on topics such as dealing with grief and loss, bullying, and goal setting. These were just a few of the many useful resources available on the website. Also all the resources on the website are available in Spanish. We welcome you to direct clients to our website. Their username is their company’s master account code (which the clients may obtain from us at the Access Center), and the password is “perspectives” for all users. The address is www.perspectivesltd.com . Short-term Counseling When you see a client for an initial assessment, one of the questions to be addressed is whether the client can benefit from short-term counseling through the EAP. Although our client companies have different EAP session models, we always staff the case with you and authorize additional sessions based on the assessment. Typical short-term counseling averages 3-5 sessions. We see short-term counseling as a different service than psychotherapy: it is focused on problem solving and often includes a strong psycho-educational component. It is also less dependent on the therapeutic relationship than psychotherapy tends to be. Our guidelines for whether a client is appropriate for short-term counseling or a referral to their insurance benefit may be helpful: Short-Term Counseling Most Z-Codes (formerly V-Codes) Mild Adjustment Disorders Minor work-related problems Relationship issues that can be resolved in a few sessions Uncomplicated bereavement Parent-Child relational Problems Stress Management Mild traumatic stress (Normalizing, coping) Long-Term Referral Most DSM-V Clinical Diagnoses Impairment in functioning Substance Use Disorders Serious relationship problems PTSD Abuse survivors Personality Disorders Supervisory Referrals – Reminders At times, we will be referring clients to our affiliates who are being referred formally by a representative of their employer. We will inform you of this when making the referral, and give you the name of the person to include on the release of information form. It is important that you get the release signed with the company name and the individual supervisor (or HR person). However, we ask that you not contact the company yourself. Generally, it will be the account manager at Perspectives who will have all contact with the company or supervisor. Sometimes the account manager will be working with you directly, and in other cases it will be your Access Center counselor who will relay information you provide to the account manager or company contact. An exception to this procedure is in the case of a DOT SAP evaluation, in which the clinician is required to send the findings on SAP forms (with the clinician’s own letterhead) to the designated employer representative. The SAP forms also contain a DOT statement of understanding that takes the place of a release of information form. Introducing our Access Center Perspectives has masters-level and bachelors-degree level staff that coordinate and provide the various EAP services that are contractually offered to our companies. Our goal is to have a seamless process for our clients to access any service that will provide them assistance. We may provide phone counseling, a phone assessment and referral, or a referral to an EAP counselor for services. Those services may be our traditional EAP assessment (one session authorized), an extended assessment (2-3 sessions authorized), or a direct referral (following a phone assessment) for a number of sessions of short-term counseling. We are also attempting to use our core group of frequently used affiliates as providers when we assess that a direct referral into the benefit would be appropriate. Our EAP contracts typically offer 1-3 sessions of assessment and referral. Companies may contract to provide an additional 2- 8 sessions to complete short-term problem solving counseling. Please address any discussions with clients about the number of sessions in terms of what will help them solve their problems, not in terms of how many are allowed by Perspectives. When discussing the plan for short-term counseling, it is best to tell them what you are hoping to accomplish and let them know you will get back to them about the plan for additional sessions. Suggested wording is, “I’m going to discuss this with ____ (the counselor you first spoke to) and let you know.” Self-Referral: Perspectives allows self-referral when the affiliate is part of the client’s insurance panel and/or when other circumstances indicate this is in the best interest of the client. This takes into account that our trusted “provider/affiliates” can provide both EAP and treatment services, and that we will be making some referrals to you directly using the client’s insurance benefits (whether managed by Perspectives or not). We will also be referring clients for a pre-authorized number of sessions for short-term counseling. We allow self-referral when clinical issues or resource availability warrant this. We ask that our affiliates discuss this possibility with the Access Center before bringing it up with the client. Sometimes, clients request to stay with the same counselor for treatment, and this is often appropriate. Whenever self-referral is approved, we ask that the client sign a “Freedom of Choice Affidavit” agreeing that they have been offered other choices, and that the costs and other issues have been explained. This prevents later confusion, especially about cost. Paperwork Notes Our clinical EAP paperwork may be downloaded here (spanish). You may also request that it be emailed, faxed, or mailed to you. Client Assessment Summary & Case Closing Form: The first page of the paperwork packet is the “Client Assessment Summary & Case Closing Form.” This contains a number of small checkboxes and is used for our utilization reports. Therefore, this information (especially the EAP Assessed Problem 1 & EAP Assessed Problem 2 and the primary and secondary referral) should reflect that a good assessment was done (EAP Problem 1 & 2) and that the most appropriate type of referral was made (Referral type 1 and 2). When listing a primary referral, you should not list “EAP” unless that was the ONLY mode of service provided. Our customers take this to mean that the person received services entirely through the EAP and no insurance benefits were used in addressing the problems. This is a desirable goal whenever possible, but we need our reporting to be accurate when we say how many people were served entirely through EAP services. When substance abuse or mental health issues are identified, the primary referral should be for some type of treatment. For substance abuse, self-help is often an appropriate secondary referral. Psychiatric evaluation should also be considered for a referral, either primary or secondary, when mental health issues are identified. EAP Initial Assessment: The EAP Initial Assessment is s guide and a place to document that you have covered all the areas we consider part of a good EAP assessment, including safety, substance use, mental health, and psychosocial stressors and supports. The last part is a record of your findings and recommendations. For the EAP problem, we want to show that we have uncovered additional areas of concern whenever possible. Therefore, use the client’s own report for “Client Problem.” For example, the client may come in reporting marital issues, but you assess that there are alcohol issues. This shows that we have provided value to the clients and their employers. We also want to clarify the line on the EAP Initial assessment that says “Name(s) of Provider(s) or facility to which you referred client(s).” This is not for your name (unless we have authorized a self-referral), but for the name of the clinician(s) or organization(s) to whom you have referred the client. If the level of care recommendation is for EAP short-term counseling, you may enter “N/A” under “Provider Name(s).” Statement of Understanding: If you work with other EAP’s, you are probably familiar with this. Our statement includes sections on supervisory referrals and their bearing on releasing information. It also describes the process of managed care, which may be provided by us or through another organization. One important point to be sure that clients understand is that while short-term problem-solving is provided free through the EAP, referrals usually involve the use of insurance and may result in costs to the client. Release of Information: We do not require a release for the affiliate to send us paperwork or talk to us. We consider you to be representing the EAP as a counselor, and this is the way the client should interpret it. You may ask the client to sign a release of your own allowing you to talk to Perspectives, and you are welcome to do so. Our paperwork contains a release that is used for two main purposes: to allow you to discuss treatment recommendations with a provider (such as a treatment program), and to allow us to confirm to the client’s employer that they have contacted us, kept their appointments, and followed recommendations. This latter will not apply to self-referred clients, only to those referred by their employer. In those cases, we always include both the designated person and the name of the organization on the release. We generally advise clients that we cannot guarantee that we can limit the people to whom information is released at their job, because they are not bound by the same confidentiality rules that govern us as mental health providers. Missed and Late Canceled Appointments: We strongly advise clients to call 24 hours ahead if they cannot keep appointments. We cannot charge them for missed appointments or late cancels, and we generally do not reduce their EAP sessions if they do. However, you are free to advise clients that you may not be able to offer appointments at the times they desire (especially evenings) if they have missed or failed appointments. Although we do not generally reimburse for a single failed appointment, we will reimburse for a second failed appointment or late cancellation. Please indicate that on your billing form or when you submit your session on ProviderFiles. At that point, you will probably want to discuss the referral with the referring counselor at Perspectives, and we will understand if you need to limit further availability. Billing and Payment The authorization form is sent at the time of the referral. We typically authorize two sessions to begin the assessment process, and ask for a phone call with clinical information after that. As described above, we sometimes refer clients for 1-3 sessions of extended assessment and referral, when that appears to be more appropriate. In other cases, we may assess clients on the phone as needing short-term problem-solving counseling, and authorize several sessions of short-term counseling. For SAP evaluations, critical incidents, and training, we negotiate a separate fee. We do not allow billing for time for paperwork and phone calls, which are part of the EAP Assessment & Referral process. We occasionally authorize 30 minute follow-up/monitoring sessions, usually for substance abuse cases where there has been a workplace violation such as a positive drug test. If you find that a complex case is resulting in excessive time for case management or phone work, please discuss that with your Access Center counselor and we will consider authorizing extra time. Please submit your paperwork and billing form within 90 days of service. The sooner the paperwork is received, the sooner we can issue payment. We have a standard of sending payment within 45 business days after the paperwork is received or accepted in ProviderFiles. Although we may send multiple authorizations, you may submit all dates of service on the same form, or copy the form for adding later sessions. We will keep track of sessions authorized and used no matter how they are submitted. We have also started utilizing an online portal, called ProviderFiles (click here to view the training guide) . The portal allows affiliates to enter clinical notes, submit/review billing, and update their own affiliate information (including licensure, malpractice insurance, office location, etc.). The following documents are required for payment: Authorization Form with dates of service and total billed Initial Assessment Form Follow-Up Appointments Form (if applicable) Client Assessment Summary and Case Closing Form Release of Information Form (if applicable–if client was referred by their organization as a supervisory referral, fill out section 3; if client is being referred to a treatment provider, fill out sections 1 and 2.) Please call if you have any questions. Thank you for working with Perspectives! Perspectives Ltd delivers an employee assistance program known as Life Enhancement, Assistance and Development (LEAD) and project- and program-based organizational services including assessments, training/coaching and critical incident support. 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