For Some requests for extra sessions requests, there is a need to be reviewed by a Clinical Manager. This happens when your request takes the total above the threshold of sessions a client can have that when exceeded, a review by a Converge Clinical Manager is required.
As Converge is an EAP service and not a long-term alternative to ongoing specialist support, a clinical review requires you to complete additional questions to justify the reason for the additional sessions that you are requesting. After completing the additional questions to justify the reason for the sessions request, it will be sent to a Clinical Manager for review.
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for a given Assist Case. You will be prompted to provide additional information to justify your request for extra sessions. The Clinical Manager then determines whether the request is consistent with our short-term EAP framework. For example, EAP cannot be used for ongoing support without a referral.
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Please keep in mind that your client may be eligible for a new Assist Case instead of extra sessions. Please check with the Clients Services team. New Assist Cases are available for a new issue (depending on the contract we have with the employer), or after 12 months. |
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Do not at any stage recommend, suggest, commence or schedule the next session with your client until the two review processes have been completed review process is complete and an outcome has been determined, as your . Your request may require further information or be declined. See the “Next steps” section at the bottom of this article for more information. |
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Step 2: Navigate to the Clinical Review questions
Once If you submit the request and it reaches this a request which triggers a clinical review threshold, you will receive an email to remind you to complete the some additional questions.
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2. Click on the ASST case hyperlink within the email (ASST-XXXXXX) which will direct you back to Phoenix.
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Step 3: Complete and submit the extra sessions “Further details” questions
On this screen, complete the further details questions. These questions are to assist with the review on whether the client having access to these additional sessions (including appointments completed and the amount requested in this request) in a 12-month period is clinically appropriate given the short-term nature of EAP. Click Submit when completed.
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Once completed, press “Submit”Complete the questions to provide further information about your request. Your responses will help the Clinical Managers determine whether it is appropriate given our short-term EAP model to ask the employer for further sessions.
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Click “Submit”.
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Next Steps
What happens next?
There are now two requests - one for the original extra sessions request (which gets sent to the client's organisation) and a second for the further questions (which gets sent to your clinical manager to endorse or reject).
Your original request is held until a clinical manager reviews the request and determines the outcome. If it’s endorsed by a clinical manager, the original request you made in quick view will be released and processed as normal. A Clinical Manager will review the additional information you have provided. If the Clinical Manager supports your request, it will be forwarded to the client’s employer for payment approval (without the client’s name or identifying details). The Clinical Manager may also reduce the number of sessions requested or decline the request. You will be notified if the request is declined.
If you do not complete the review questions, the request will not proceed.
How long will this take?
The original request from quick view will be held until the further questions request has an outcome from a clinical manager. It can take up - to 5 working days for a clinical manager Clinical Manager to review and determine an outcome. If the further questions request is approved by a clinical manager, the original request from quick view is released and processes under the normal time frame which is up-to 8 working daysyour request.
Then, the client’s employer has up to 7 working days to approve or decline payment.
The total time for both requests is therefore up - to 13 12 working days.
How do I view the status of an extra sessions request?
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