A behavioral health professional’s description of a problem after making an evaluation.
What is a clinical diagnosis?
Child who shows symptoms of a disorder.
What is an "affected child?"
A condition that interferes with a child’s ability to learn or function at the same level as other children the same age.
What is a disability OR disabling condition?
Symptoms that are both temporary and severe.
What are acute symptoms?
A medical doctor or nurse who has extra training in behavioral disorders. Licensed to prescribe medicines.
What is a psychiatrist or licensed psychiatric nurse practitioner?
Treatments that are necessary for a patient to be appropriately treated for certain symptoms.
What are medically necessary treatments?
Standards that must be met in order to be included in a category (often for becoming eligible to receive services).
What are criteria?
A formal request for a decision to be changed by a higher authority.
What is an appeal?
Types of treatment that an insurance plan will not pay for.
What are exclusions?
A set of facts that can be observed and measured.
What is evidence?
A professional (with a PhD or PsyD degree) who is trained and licensed to evaluate or do problems therapy for behavioral or developmental. CANNOT write prescriptions.
What is a psychologist?
Also called “coverage.” Services an insurance company to pay for if the right conditions are met.
What are benefits?
The range of care options available for patients, ranging from an office visit to inpatient hospital treatment
What is a continuum of care?
A symptom or condition that is present (or reoccurs) over a period of time.
What is a chronic symptom or chronic condition?
A contract between an insurance company and an individual or family.
What is an insurance policy?