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great welcome everybody to navigating opum supervisory protocol with Thrive Services um my name is Ashley Secord I'm here with Molly Greg Molly do you would you mind introducing yourself absolutely um I am Molly I am the project manager and I also do some billing work with Ashley at Thrive um I've been with the company for going on four and some change years now um and so I'm I'm excited to step into the project management role a little bit more um and kind of be the point of contact for everybody on the call as needed awesome thank you my name is Ashley I started Thrive Services just over five years ago um I saw a little bit of a gap in the community for mental health professionals with billing and credentialing Services um and it was something that I had been thinking about probably for three years leading up to that point in addition to owning this company I also have a private practice in the state of Minnesota and in the state of South Carolina um so I would say that I have a lot of experience and have learned a lot of things along the way the supervisory protocol um with opum is one of those uh one of those things that I have gone through and feel like having a workshop and resources available to Providers would be really beneficial um outside of the information that opum also provides so that was sort of the brainchild for this event going into this I give you a little um overview we will be looking at the supervisory protocol audit I will share screens of the actual audit tools that they provide you um we'll review steps to prepare your private practice with the required documents um we'll also address the emotional side and talk about ways to reduce anxiety leading up to the site visit uh as well as resources for making your audit go smoothly before we do that I just want to get a little bit of information from you guys if you don't mind sharing share as much or as little information as you would like where is everybody from where is everybody calling in from Minneapolis great awesome lots of Minnesota people I'm I I I feel like I typically connect with a lot of people in that in that area Maryland that's great awesome lots of Minneapolis I love it excellent thanks for being here excellent how many contractors or employees does your practice have great excellent you guys are all wow amazing excellent great and then how many of those contractors if they are contractors are pre-licensed staff or maybe you don't have PR pre-licensed staff okay great awesome we got the we got the full spectrum excellent how many of you you are familiar with uh uh the optims supervisory protocol or know somebody who's gone through it and if you if you don't that's fine um I know some people have connected with other therapists who have gone through it or heard through it through their insurance company okay oh amazing somebody's going through it currently yeah Okay cool so so some of this information might be new some of this information um might be repetitive I want to give like a full picture of what the what the supervisory protocol is and um if you have any questions along the way please use the chat box to um ask for clarification if I don't see your question Molly will definitely um tap me on the shoulder to make sure that I answer it great so the supervisory contract is um here's the definition it was actually a a manual I saw somebody here from Maryland Maryland actually has a really great um uh like I think um what is it just a document that goes over the supervisory contract very well and I pulled this from their manual uh it's a gr contract that allows non-credentialed CL clinicians to render Services while under the supervision of an independently licensed clinician and they use the word non-credentialed here I would use the word pre-licensed um that I don't think anyone is using um using this contract to bill for other fully licensed providers uh I would say that this is typically for billing for those in uh inter or the The Graduate level pre-licensed providers the terms of this contract are that clinicians are rendering Psychotherapy Services and they have at least a master's degree the services that are rendered are within the scope of the clinicians training supervision must occur regularly on a one-on-one basis and be documented and that opta may periodically conduct a chart audit to ensure the compliance with their policies and procedures this is what the timeline looks like in order to uh start the process for um obtaining your contract so the first step is you'll request a supervisory protocol contract um so you'll I'm going to show you the resource and actually provide you the link in just a second um so you'll go to the provider express.com to find your provider relations Advocate to formally request this addendum once you have five fully licensed providers on staff so I will show you I have this here um so I'm going to send you this link first and that will bring you to the states and then I have the Minnesota one pulled up specifically um that will show you once you click on it um it'll show you your provider so let's say for Minnesota it'll show you all of the counties that that your provider is um which representative is your provider for your county so that's the person that you would reach out to for your um addendum that is there so um for the Minnesota folks I will send this one excellent two Master's level clinicians excellent great so from there once you send the request you will um you will then be responded to from an Optimum clinical quality analyst and they'll reach out to you via email and phone to review the information with you once your request has been accepted um and then they'll they'll you'll start to get all of the information all at once and then they'll set up a phone call to meet with you to go over all of the information um and this quality analyst is um we we'll kind of step into that next that quality analyst is a a mental health professional as well so in the state of Minnesota you might have an lpcc or an lmft who's going to be reviewing your documents um that'll be your your auditor will be um a essentially which um I think is just kind of nice to know um the next part of the timeline is I would recommend reviewing the audit tools I probably read through the audit tools like no joke probably 20 times um in the process of like reading through okay what do I need reading through and figuring out which information I had and didn't have reading through make sure I had what I said I had like it was just the sort of repetitive thing um to make sure that all of my ducks were in row and all of the list all of the items on the list were um in the documents that I had listed uh preparing for the site audit um they have a secure portal that allows you to upload documents once you have completed them um I highly recommend use utilizing this they won't provide you access unless you request it uh they let you know at the phone call at your initial phone call that you are um that you can have access to this I cannot recommend it enough ultimately it essent it just lets you like upload upload upload and the more information you upload for them to review before your audit uh the less time they're going to spend at this at your site audit visit um so that 4our visit can um my my visit ended up only being an hour because I uploaded every single document I possibly could beforehand so it ended up being more of a conversation by the time the site audit arose that site audit is a conversational review of your documents process processes and site with your clinical quality analyst um it was very uh very casual very relaxed uh they have recommendations if something was missing from some of your documents um but it's certainly not a um like this hypercritical judgmental experience of your site or your documents it's more like we didn't notice this we recommend using this language that type of thing any questions so far all right looks like oh two questions um I'm what I will do is I'm GNA send a vid this video to all of you um after the um after the presentation if you are teleah health I'm actually that's a good question that I would maybe ask your Advocate because I did have a site um but I do think that um uh like the site audit visit I'm wondering if it would be an obstacle because a lot of the tool is about your physical location and they might have questions about supervision for pre-licensed providers like how are you overseeing their I I I know it's not that different but um it might be uh it might be good question to ask like your Advocate and does an lmsw count as licensing reference five licensed to initiate the agreement uh is the lmsw the licensed Mental Health social worker is it a is it a okay and is that is that uh in your state is that that considered okay in your state is that considered fully licensed no um then probably not I would guess not um I would say uh if in I'm not familiar I think you said you from Maryland um I'm not familiar with the credentials but I know in Minnesota we have like we have three like Master three or four Master Level and then we have like uh the LPS and the and like the sort of doctorate level and those were the ones that were considered the fully licensed um clinicians and everything else was considered like a pre-licensed but again a super great question to ask your uh Advocate but I'm going to surmise that it's probably not included any other questions yeah you're welcome uh just to reiterate I think I mentioned already um contact the provider relations advocate for your area varies by state varies by county and I already gave you the links same thing Optimum quality uh optim clinical quality analyst they will reach out to you it's a mental health professional um and there will be your point of contact leading up to the audit and will be the person that you meet with um for your audit uh something I didn't mention is typically when you request the audit they try to schedule the site visit within a month um it's a pretty small at least in my experience it's a smaller window um so it's just something good to keep in mind if you're starting to prepare or get some things in order um if you're only one clinician away uh from like having five fully licensed staff um this might be a good time to of put some of these pieces in place so that when you do apply for the audit you're sort of like okay I'm I'm completely ready to take this on or I only have a few things to put in order that sort of thing um somebody asked does everyone have to have an audit um I just got credential to have the supervisory protocol added to my contract that's excellent um I ours included a site audit and you're in Minnesota too suum did you say where which where which state are you in oh she's in Rhode Island that's right yeah okay um I I'm under the impression that the audit is a part of the process um if if if Rhode Island doesn't include that I will say in the state of Minnesota we have a a site audit um but I do like if if you if you just got credentialed with it that's awesome and is it already like uploaded and and going oh okay okay you're in the process sounds good yeah um so the like the audit I think using that word um they're all audit tools so that you'll see in a second once we review that um the audit tools will like you'll see all of these sort of line items that they go through to make sure like ultimately this quality assurance is um they're they're wanting to ensure that your pre-licensed providers are are are providing the same level of care and have the have a high level of supervision from fully licensed providers uh to their members so if they're going to be compensating us for these uh pre-licensed providers uh they want to ensure that you have policies and procedures in place that they are providing a a as high of a level of care and are being overseen at that high level as well okay so these are the three audit tools that we're going to go through um one is the agency site tool which is the environment of care your policies and procedures and Human Resources the treatment record tool is their review of three Case Files two will be um inactive and one will be active and these can be um non optim clients but I chose optim clients to um send over just because that's just one less layer of like Hippa affiliation on my end they clients have already signed off on providing access to their records to um to their insurance company so I I use I recommend using opum clients um if you have at least three and then the supervisory protocol tool this is the shortest briefest of the audit tools um proof of supervision by a credential supervisor and then they want a the supervision policies and procedures that you have in place as well starting with the agency site tool these are the nine uh areas that they cover in that site tool the environment of care rights and responsibilities Safety and Security addressing infectious diseases treatment records how complaints are managed how uh treatment access from clients patient safety and Service delivery in this I will show you an example of a tool so this is a snapshot of the actual tool um this is the very first page environment of care um facility location is easily identifiable from the street furnishes furnishings and Decor are appropriately professional waiting room and patient care areas are adequate size and reasonably comfortable no culturally offensive materials fire safety plan exits are well marked free of obstruction pretty straightforward it's very yes or no on on those first items um and then you start to get to like you're like okay yeah like I don't have any offensive materials posted and then it starts asking about a safety plan it starts asking about fire extinguishers or a fire suppression system so some of those things uh if you don't already have them in place or don't have an have um an actual facility those are good things to follow up with with your um Advocate to see if there's you know maybe there there's a a tella Health version of the audit and you'll just so you know you'll receive a copy of this when you hear from your analyst like they will provide you all three tools for you to review here's another page um policies addressing Safety and Security policies and procedures for dealing with life-threatening emergencies um policies addressing uh control of hazardous materials cleaning supplies and waste uh policy addressing management of any spills of bodily fluids that was a very new one for me I was like I don't think I've ever really considered a policy for that and they they mention a little note here they say at your level of care AKA if somebody vomits or cuts themselves um that I was like okay I guess that like that could happen in a in a therapy office one more page here uh the policy or written criteria for assessment procedures includes evaluation of learning needs and barriers to learning so this would be like in their um treatment plan or evaluation assessment procedures includes mental status exam um assessment procedures uh includes risk assessments and criteria for assessment procedures includes identification of community resources used by patients I mentioned that one because that was something that they had brought up in in my audit they had um for some of the like termination notes they had recommended including language for like resources that would be available to the client as a recommendation so I wanted to I like to point out that one um their emphasis on Community Resources and then criteria for assessment procedures includes identification and prominent listing of relevant medical conditions lots and lots of icies and procedures I I will show you we're going to show you a resource at the end but we have a policy and procedure manual that has that includes all of those um requests for uh that treatment tool including the other ones um just so you can see here we'll review this in more detail as we get closer to um the end of it but um I just want you to know like when I first read uh when I first read through the audit tool I like I don't know if I had a panic attack but I certainly had some anxiety Rising where I was like what I this event as well uh because I was like I like I have I do have some of these policies and procedures written but I don't have a lot of the ones that they're asking for um so sort of getting the word out is I think helpful for providers who might be looking to start this process before they apply um because having that small time uh that time crunch window um almost made it a little bit more elevated second the treatment record tool like I mentioned before it's a review of three treatment records two active one inactive and that there are seven sections in this um audit tool General documentation standards initial assessment treatment planning progress notes uh they have a medication management section if you do not have that in your um if you don't utilize that in your clinic it's it's not applicable uh I caps locked coordination of care they expressed that this is a very important area um so we'll spend some time looking just at that particular slide and then as well as discharge and transfer so I will show you those slides this is the first page of the treatment record audit tool again they start off pretty cut and dry each client has a separate record if you are using an EHR this is an automatic yes um each record includes the client's address employer or school all entries of the record include responsible service provider's name professional degree and relevant identification number so this would be your signature at the end um if again if you're using an EHR where you use a digital signature or checkbox that signs off this would again check that box uh the record is clearly legible and someone other to someone other than the writer um evidence for of a consent of treatment or informed consent on record that is signed by the client or legal guardian if your EHR has your client signed these documents in the eh that is that's sufficient documentation that the service provider provides education to client and family about service planning discharge planning supportive Community Services behavioral health problems and care options documentation that the risk of non-compliance with treatment recommendations are discussed with the client and or family legal guardian so think of this as like your notes are all representing this this isn't this isn't policies and procedures this is um they're essentially looking at a full case file for three clients two of which have um are no longer working with you and have like your termination note recommendations all of that that's all they're pulling this data from pull the next page oops skipped one some more examples you can kind of see like the numbers on the left here this is you know probably four pages in um uh screening indicates an active alcohol or substance use problem um the substance identified is being misused was alcohol um some of these are non-scored items uh the treatment planning side there's documentation or assigned form and a progress note that the client or legal guardian has agreed to the treatment plan the treatment plan is consistent with the diagnosis uh the treatment plan has objective and measurable short and long-term goals and includes estimated time frames for the goal attainment and that that's I feel like that's built into a lot of our treatment plan EHR templates the treatment record includes a safety plan when active risks or issues are identified and then the last one is the cordination of Care One um it's it's its own page all by itself um it's highlight in pink and um I think emphasizes their level of their emphasis on the importance of coordination of care so they're going to be looking for if the patient has a medical physician if we requested that information and if we requested um coordinating with that physician and it can even be that we asked and they said no and that was the the that was it it can be yes and we reached out and they never responded um that that sort of demonstration of having reached out is sufficient um and then if you reach out and they respond and you have um you had a conversation that you're showing that documentation of that contact with that PCP and that's all here the documentation or refuse consent um if the if the patient is being seen by another Behavioral Health CL clinician uh record documents that the patient was asked whether or not theyve being seen by another behavioral clinician documentation I we all I think we're all very familiar with coordination of care they're looking for that specific um documentation of all of that any questions so far about those two tools I see starlane since we have nine total clinicians in the practice three owners six employees any guidance which providers clients to pick from for the treatment record at it or would it make most sense to use clients of the provider who we actually providing the supervision that's a really great question so I will tell you what I would recommend is going through the treatment record tool to see like what boxes needed to be check and I would go look for the clients that sort of have the fullest record that check all of those boxes um so it doesn't the the clinician really isn't um I'm going to use the word important it can be a pre-licensed provider it can be uh a supervisor a supervisor it can be um just a fully licensed provider so if you have a lot of um clients to draw from uh then I would just I would just pick the ones that that like sort of fit the criteria that like best fit the criteria for that another another thing too like going into the audit if you get a new optim client knowing you have all of these boxes that they're wanting to check you're sort of going into that new client and um you're you're making sure that like you're like there's a fine tooth comb like that you're making sure those boxes are checked going into the new um the new client as well but for those Ina but I guess for the inactive ones yeah I would just I would just I would make sure not I would just look for the ones that you know have that coordination of care box checked that are have a really thorough um da and are like like very detailed like I would look for the clinicians who are the most detailed that would be my recommendation I ended up using yeah you're welcome um I ended up using mine because it was just easier to know like like my the which clients of mine um I had that type of information I even had one um for like to be able to demonstrate the risk assessment that sort of thing but that's also like if you don't have a client with that that's that's also fine yeah any other questions great we will move on to the supervisory protocol tool this is just a two-page um uh Tool uh it's a supervisor review supervis review supervision policies and procedures documentation of recurring supervision and informed consent so I will just show you the tool first uh the CL clinical supervisors are optim ubh credential clinician there's a written policy addressing the supervisory protocol utilized at the clinic the patients diagnostic assessment treatment plan and changes in diagnosis are reviewed and signed by the clinical supervisor so if your EHR is set up to have the supervisor sign your pre-licensed staff uh notes then that's that sort of meets that criteria already uh clinical supervisor reviews and signs the patient record at least every 30 days um so that one would be like that that at least every 30 days think of that more more as a policy and procedure uh and less like how do I show that my how do I show that my supervisor is signing those every 30 days um that's more more policy driven than I would say like here's when they signed it here's when they signed it right like that might be a little bit harder to demonstrate or just more paperwork verification of the supervisor uh supervises training and education is documented and avail for review so think of that as a resume um or a validation of their transcript something along those lines documentation that the supervisor and supervis meet regularly on a one-on-one basis for supervision Um this can be like a screenshot for um from the EHR uh like however you have your supervisors document their meetings um we have our supervis document it in the actual EHR system like the practices EHR system so that it's just very visible and very obvious when they're meeting and when they're not meeting if a meeting is cancelled that sort of thing if it's docu it can be documented that's just how we document you can document it in a in a shared file you can document it in um in any way that you want to just has to be visible uh supervisor's education level meets the state clinical loal supervisory requirements and or the supervisor's education level is consistent with the supervises in my uh in my world in Minnesota um this isn't necess this isn't necessary but um having an lmft supervisor for our lft clinicians is how our supervision is set up and how we um have them like have their note sign I also think it's important that they can sign up on their their their hours uh for lure um so our LC our lgsw are lined up with our our supervisor lcsws um lcsws and so we have those sort of like matched up so that that sort of policy meets that requirement in in my mind that translates very easily um a lot of States like insurance companies don't necessarily require that that tier like they just want a license supervisor overseeing the pre-licensed supervisor and some insurance companies don't even have that clinical supervision requirement oddly enough um however I do think it's sort of like best practice to have some level of or some training in that that clinical supervision um like system so I'm guessing that a lot of you probably already have that setup as well um so just having that documented and in place is is just like you'll it'll be an easy check box right any other questions we're going to switch to Preparing that's I I kind of showed you examples of all the tools I will tell you if I went through every single page on the tool we would this would be a much longer meeting it is very extensive um there are a lot of bullet points some of them are very easy like do you have any offensive material in your waiting room no and then there's other ones like um tell us Sentinel events policy and procedure and I was like I don't know what a sentinel event is I need to figure that out um so it's very thorough um but I want to make sure that we sort of if there's any questions sort of about that part um we answer those first before we go into preparing okay I think we're okay great so this is again just a suggestion you if you already are are a very organized person and um are like feel very apt to taking taking it on um by all means but this was just how how it made sense in my world for organizing the information and getting prepared for sending it sending the information over so have a plan of attack for assembling the documents and files that you have as well as the documents you need so as we mentioned before review the audit tools and review them again and review them again um I downloaded mine onto my iPad and highlighted the things that I needed and then used a different color to highlight the items that I um that I already had start collecting documents and I'll we'll go the next slide will show you which documents that you might already have to be able to draw from um selecting client records are starting to review client records um and then sort of focusing on What's Missing so we'll go through those we're going to start with collecting documents so if you are in a clinic you have staff you have employees I'm going to guess that you have some type of manuals or have started policies and procedures or you have people doing processes out of order so then you're like we have to update that and make sure everybody's doing something the same so any sort of collective document that have um where you have staff even contractors reviewing that's going to be important information to to read through and see if it matches up with some of the requirements in the audit tool so this would look like a policy and procedure manual if you have any employee manuals if you have a supervision manual and it can just it it might not be a manual it might just be a policy that you emailed out to everybody like reviewing those emails would be really smart um and in your informed consent is going to have a lot of that first uh um not the treatment tool um but from that first audit tool you're going to have like that your informed consent is going to have a lot of those policies and procedures that you're relaying to clients uh you'll be able to pull some of that for your um for your audit and you don't have to you don't have to separate those things out this is probably helpful information you don't have to divvy all that information out and highlight for them and be like this is number three you can just know that number three is in and like let number three number eight number 12 are all in your informed consent and you can upload that document and they'll check it off like you don't have to like you don't have to clean anything up for them you can just say yep I have that it's in this document they'll review it they'll check it off like it they're it's really like helpful uh your contracts with staff supervisors and employees uh that information they there might be information about your uh supervisory policies and procedures in there um like verification and requirements for hiring uh staff and supervisors all that information again you can just upload your contracts and be like yep that checks off these these and these in your mind you don't have to tell them which boxes it checks Personnel files and client records um I will tell you the Personnel files um something that was that like I hit the easy button on was um if you're Pro if you have access to any of your clinicians like uh credentialing portals like if you did provided credentialing and they authorized you to do credentialing for them um I copied I took screenshots of their like clinical history their um their license like that that credentialing portal has a lot of the documentation requested in the the tools and I just took screenshots and sent that in instead of recreating a document that had all of that information uploaded that and it and it checked all those boxes so that was like a little like Easy Button like let's that like we have all of that all every clinician has most likely has a caq if they're accepting insurance and all of that those are Personnel files for as far as I'm concerned and has all of the information that we need for our clinicians and then finally client records that one I think you guys already knew um just by a show of hands and this is there's no shame in this at all does your practice have like some of the policies that we have discussed drafted or emails or Communications um are you are you are your wheels starting to spin about like okay like I might have some of this stuff already great awesome perfect um going into more detail about selecting the client records um you asked like we had a question earlier about um which records to select thorough data collection at the onset of therapy of really detailed intake summary the coordination of care finding that clinician that or the the client where that coordination of care is documented um is going to be really important to this specific audit and efforts to reach that client's PCP and then termination outcome that you're you're putting that outcome recommendation and referral listed in that termination and then this one is like like ultimately where you'll be spending the majority of your time outside of uploading documents is what's missing uh what might what items on the tools remain after reviewing your documents and policy and then just start that list of items that need generating or editing or creating and then organize a list based on the manual and document they belong in just so you can cross reference when you check it off you're like you know which one you're going to because again those audit tools are like outside of the supervisory protocol one um they're just really long they're a lot to pull from so knowing knowing which which documents are needed for which one is is sort of helpful um and if you if you if you are missing or don't have policies you can start to like create those um as you go are there any policies and PR procedures that you heard about that you're like yep I definitely need those and if nothing comes to mind that's that's okay too yeah bodily fluids LOL yeah that was a that was a weird one I was like kind of cracking up yeah there's a whole like infectious disease one that I was like okay um all right I need to like put something together for this awesome great um so here's a little audit strategy that is a brainchild out of the uh high amount of anxiety that I experience going through my audit um don't try to do it all at once I would certainly um try if you are an eat the frog type of person where you want to do the hardest parts first start there if you're like I need to just get done what I can get done so I can focus on the harder ones go upload all of those documents that you know you do have start tracking that stuff down start rereading them to know so like just getting familiar with what you have and what you need like that takes a little bit of time so just rereading some of that blocking off time each day or week to commit to it and and like really focus on it can be very helpful using the audit tools as your actual checklist like I said put it on my iPad if you print them out um just sort of uh use utilizing that tool instead of recreating it um I I think is really helpful because that's exactly what they're using to go through your materials um and then I just listed it's no time to be a perfectionist uh they like I mentioned they will accept so much information um they'll AC accept screenshots they'll accept um like your informed consent policy and all of the documents that are all of the policies that you have listed there uh your contracts they'll accept all of these sort of documents that you have already as they're checking off all those boxes so I don't you don't need to have it necessarily like all in this sort of clean little you know bundle what is I like to ask this question um because I know what my reaction was when I got the audit tools what is your reaction as a result of seeing like pieces of the audit tool and um uh like hearing hearing about it I guess any any initial reactions or responses and it might just be like yeah no big deal I already have all that stuff I'm just going to send it in or it might be like what am I getting myself into this is my M what third or fourth time hearing all this information and every single time I still go wow there's a lot sure sure yeah Annie said this is like she expected this that's great um feeling word oddly calm and excited that's amazing I'm that is awesome I'm happy to hear that and you are welcome great Okay so none of you felt anxious so those of you who might be feeling anxious and didn't mention it or I'll just remind myself um the audit is a conversation between colleagues about the documents you provided um you're literally talking with a peer they are very kind and and um this is not their first audit and I'm like yeah they're they're it's it's certainly not this like what are you doing wrong let me find what you are doing wrong it's certainly like they want you to pass they want like if there if they notice something they're like yeah let's let's fix it um optim wants you to be successful and ensure you're providing the appropriate amount of support and oversight to supervises and there are no consequences to not passing they're not going to remove what access you have to your op your current optim cont contracts um and then lastly you're probably going to pass like there's I don't think I've heard of anyone not passing um if you complete the majority of this information and submit it um yeah I I've not heard of anyone getting less than like a 90% on there and it is there is a percentage because they have all of these like calculations or whatever um yeah I think like just kind of keeping that in mind during the process but you're all really calm and collected so I don't know don't even worry about it um just so you all know we so as a as a part of processing my anxiety from my own experience uh we have a policy and procedure template um that I showed you I did show you the um uh the table of contents it's 25 thorough policies required for the supervisory protocol audit each policy can be customized to your practice it includes policies and procedures for the treatment record supervision and supervisee Clinic site and Human Resources I'll show you the um table of contents again um just so you can see like we have the infection control the incident report or the Sentinel events policy we even have the spills and bodily fluid policy in there um we have uh supervisors and pre-licensed staff we have the whole supervision um supervisory policies and procedures in place and then I'm just going to show you a few examples of what those look like so you get an idea of that it is a very editable document um so it's very thorough in the policy and then it will gives a place to add your private practice information and uh and I also pulled up I'll show you a few examples and then I'll show you which uh there's a few policies that are not included because they're not really necessarily like one's like a pet policy and if you needed one I think you could probably um find one um grievance policy that's built in um this is just like partial page like a lot of these these policies and procedures are about one and a half to two pages um depending on on the policy itself the complaint one is a little bit longer here's the infection control um policy again you can see like which ones have it I will say if you're in the state of Minnesota this is very state of Minnesota friendly however we have them all blocks stuff for you to enter your state information um each department of health has an infectious disease epidemiology ology prevention and control like you'll be able to look up that number and enter it um without having to draft all of the sort of details of the policy and procedure so um this is the policy and procedure manual I used for my audit um and it it covered like there was absolutely no questions about any of of the policies and procedures listed um we're offering this we normally charge about $800 um for those of you who are participating in this event we're marking it off uh 25% and it's only $600 now um so if you want to uh access this you can just email info thribing services.com before Sunday at midnight and just send us the code summer savings if you don't add the code and just say you attended we will also give you to you for that price point um it's a 45 page document again covers all of the policies that you listed I'm actually going to pull up the page these are the only ones uh this is the very first page of the document oops it's not sharing hold on one second oh yeah it is showing okay um so you'll see these are the only ones that are not um there's not a policy listed because they'll either be included in your um informed consent already and I actually think I did add the pet one like if um there's like an animal policy so that is included in the policy and procedure manual um but these these specific policies that they ask for in it um that's that's built in to uh what what I would think would be in the informed consent and I was like I don't think I need to write an informed consent for people um so and then the assessments of Staff competency I feel like that varied enough for it to be included um uh that that would be something that each individual practice would have on their own yeah um um I think that is everything in addition to the supervisory protocol policy and procedure manual we also offer Contracting and credentialing monthly billing packages special projects um we provide a lot of that administrative support um and if you're interested in any of that if you want a free quote you can visit us uh you can use this QR code um otherwise you can visit us at our website at Thrive billing services.com and get information there yeah Ashley Sterling had a question about um the they had heard um that the supervision protocol um had been paused have you heard anything about that yeah so I heard that so I reached out to um uh the rep for my county and they they mentioned that commercial plans were paused and but to reach out to your um reach out to your advocate for like the most upto-date information and they but they I also know that they are still allowing like Medicaid plans to go through so um she didn't really elaborate on any of that but I would um I would certainly reach out like if you found your advocate in um on that list or through that list that I uh provided a link to and if you didn't if you came in after I sent those links I resend them again um that they they would have the most upto-date information but I'm very curious to hear I I didn't hear about the re-evaluate part I I I just insurance has always like pause or um open up their plans um so we'll see and if they do a re-evaluation um we'll we'll do an updated event to see what it includes does that answer your question excellent great any other questions thank you all for staying and being a part of this event I really like talking with providers and helping them grow and expand their practice it's um very it's a it's like a fun business side of this this world all right well great well thank you everyone I can't believe we got through all of this in just under an hour if you either of you need anything please let us know don't hesitate to reach out we'd love to hear from you yes thank you thanks for coming thanks bye bye