Start of the day
After the morning meeting
There are the notes you took during the morning meeting. Things to follow up on. However, you look at your appointment schedule first. There is an appointment scheduled with one of the clients on your caseload, but this person is not yet checked in. What you don't know is whether the front desk forgot to check the person in, or if the person has not shown. You will wait a few minutes. Normally it is recommended you wait only five minutes before making the client reschedule. You like to give a few more because maybe there was an issue with the bus the client was riding, or maybe the person is stuck in traffic.
You take this opportunity to briefly check your emails. At the moment, there is nothing you need to reply to or even act on. It's pretty much just people replying to each other over some thing, cc'd to the entire case management, front desk, and medical assistant teams. You delete them because otherwise they will jam up your email inbox. The client has not yet shown up. It's six minutes in. At seven minutes the client shows as signed in. This is good because you can bill for this appointment. You go to meet him. You go to the front lobby and call his first name. He gets up from his chair and says hello. You accompany him back to your cubicle--not the most private space, but it's what passes as your office.
You ask him how he has been. You have a genuine interest in his well-being, to be sure. He says he's doing okay. You are listening for cues such as any hesitation, tentativeness, his voice tone not matching what he's saying. Really, it's hard to tell. He apologizes for being late. The bus was running late. You understand. Because the front desk staff did not note down what the appointment was for, you ask him. He tells you he would like to get a job, and needs help. Can you help him?
Of course, you are interested in helping him out. However, this also presents an opportunity for extra billing, so you use this as an opportunity to bill an additional unit using the pre-employment code. You ask him a set of questions and record his responses so that they can be put on a note for this purpose, for the extra billing. You spend some time with him and offer to introduce him to the employment specialist working elsewhere in the building. He agrees with this. You also have to do some due diligence, and ask him (due to his history) if he is having any thoughts of harming himself. He answers no, not at this time. You go through a set of questions to help assess current suicidal risk. Due to his previous history of having such thoughts, this is all good to ask. However, you have been reminded over and over again to bill assessments as much as possible, as they pay the agency better, and you fully intend to write an additional note to support this.
You accompany him down to the employment specialist's office and do the "warm hand-off," where you introduce him to the friendly employment specialist and explain that he has interest in finding a job. The employment specialist starts her work with him. You walk back toward your cubicle. You have some time to write your notes now, and start writing them. You write the note for the case management. You hesitate to write the note for the pre-employment code, however, because you do not remember at the moment if you can bill for that so closely to the time the employment specialist will use. You decide to include that in the case management note. You then write the note for the suicide risk assessment you did with him. All told, you were able to bill 10 units!!!---but no, wait, the CEO decided to reduce the assessment units to 5 instead of 8, so now you remember that it's only 7 units total. Still,that's something.
You remember to look at your email. There are two emails from your supervisor, one seeking information about something, the second asking why you haven't answered yet. Well, that's easy. You did not answer yet because you were working directly with a client, providing what you hope was meaningful face-to-face assistance for him. You start to type an email to answer the question, being careful to start with an apology and an explanation that you were meeting with a client. You finish it and send it. Also, there are a bunch of other emails that you got while working with the client. Some of them are asking or insisting on your response ASAP. While you are busy answering the first one, your desk phone rings. You answer it. It's a call from someone at the RBHA (regional behavioral health authority), seeking some detailed information about a situation with a shared client. This cannot be put off, of course. You spend 15 minutes providing a detailed answer, going through notes and emails. Another 2 minutes are spent agreeing on a follow-up plan, to be done by tomorrow. The requests from the RBHA are very reasonable and important. Once you are off the phone, a couple of more emails have come in that seem to require immediate answers. You start to wade through the backlog, and are pretty sure that you will hear about this at your next "coaching" later this week. Oh, yes, you really should write a note about the phone call with the RBHA. This is considered case management, so it's another unit. But the emails will will have to come first.
So basically, you've earned 7 billable units so far today, another 1 pending if you can write the note (really a very good idea), and you are looking at possibly getting some grief from your supervisor because you didn't grow a second brain to respond to the emails while speaking with the client. You are not sure at this point how much you care, except that you really do need to keep a job. So you basically grin and bear it for now.
There are the notes you took during the morning meeting. Things to follow up on. However, you look at your appointment schedule first. There is an appointment scheduled with one of the clients on your caseload, but this person is not yet checked in. What you don't know is whether the front desk forgot to check the person in, or if the person has not shown. You will wait a few minutes. Normally it is recommended you wait only five minutes before making the client reschedule. You like to give a few more because maybe there was an issue with the bus the client was riding, or maybe the person is stuck in traffic.
You take this opportunity to briefly check your emails. At the moment, there is nothing you need to reply to or even act on. It's pretty much just people replying to each other over some thing, cc'd to the entire case management, front desk, and medical assistant teams. You delete them because otherwise they will jam up your email inbox. The client has not yet shown up. It's six minutes in. At seven minutes the client shows as signed in. This is good because you can bill for this appointment. You go to meet him. You go to the front lobby and call his first name. He gets up from his chair and says hello. You accompany him back to your cubicle--not the most private space, but it's what passes as your office.
You ask him how he has been. You have a genuine interest in his well-being, to be sure. He says he's doing okay. You are listening for cues such as any hesitation, tentativeness, his voice tone not matching what he's saying. Really, it's hard to tell. He apologizes for being late. The bus was running late. You understand. Because the front desk staff did not note down what the appointment was for, you ask him. He tells you he would like to get a job, and needs help. Can you help him?
Of course, you are interested in helping him out. However, this also presents an opportunity for extra billing, so you use this as an opportunity to bill an additional unit using the pre-employment code. You ask him a set of questions and record his responses so that they can be put on a note for this purpose, for the extra billing. You spend some time with him and offer to introduce him to the employment specialist working elsewhere in the building. He agrees with this. You also have to do some due diligence, and ask him (due to his history) if he is having any thoughts of harming himself. He answers no, not at this time. You go through a set of questions to help assess current suicidal risk. Due to his previous history of having such thoughts, this is all good to ask. However, you have been reminded over and over again to bill assessments as much as possible, as they pay the agency better, and you fully intend to write an additional note to support this.
You accompany him down to the employment specialist's office and do the "warm hand-off," where you introduce him to the friendly employment specialist and explain that he has interest in finding a job. The employment specialist starts her work with him. You walk back toward your cubicle. You have some time to write your notes now, and start writing them. You write the note for the case management. You hesitate to write the note for the pre-employment code, however, because you do not remember at the moment if you can bill for that so closely to the time the employment specialist will use. You decide to include that in the case management note. You then write the note for the suicide risk assessment you did with him. All told, you were able to bill 10 units!!!---but no, wait, the CEO decided to reduce the assessment units to 5 instead of 8, so now you remember that it's only 7 units total. Still,that's something.
You remember to look at your email. There are two emails from your supervisor, one seeking information about something, the second asking why you haven't answered yet. Well, that's easy. You did not answer yet because you were working directly with a client, providing what you hope was meaningful face-to-face assistance for him. You start to type an email to answer the question, being careful to start with an apology and an explanation that you were meeting with a client. You finish it and send it. Also, there are a bunch of other emails that you got while working with the client. Some of them are asking or insisting on your response ASAP. While you are busy answering the first one, your desk phone rings. You answer it. It's a call from someone at the RBHA (regional behavioral health authority), seeking some detailed information about a situation with a shared client. This cannot be put off, of course. You spend 15 minutes providing a detailed answer, going through notes and emails. Another 2 minutes are spent agreeing on a follow-up plan, to be done by tomorrow. The requests from the RBHA are very reasonable and important. Once you are off the phone, a couple of more emails have come in that seem to require immediate answers. You start to wade through the backlog, and are pretty sure that you will hear about this at your next "coaching" later this week. Oh, yes, you really should write a note about the phone call with the RBHA. This is considered case management, so it's another unit. But the emails will will have to come first.
So basically, you've earned 7 billable units so far today, another 1 pending if you can write the note (really a very good idea), and you are looking at possibly getting some grief from your supervisor because you didn't grow a second brain to respond to the emails while speaking with the client. You are not sure at this point how much you care, except that you really do need to keep a job. So you basically grin and bear it for now.
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