Extra Sessions - Clinical Review: Practices

Some requests for extra sessions 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 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.

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.

Do not at any stage recommend, suggest, commence or schedule the next session with your client until the review process is complete and an outcome has been determined. Your request may be declined. See the “Next steps” section at the bottom of this article for more information.

Step 1: Complete an extra sessions request in Classic View

You’ll need to make sure you’ve submitted an extra sessions request in Quick View first. After submitting, proceed with step 2.

Learn how to request extra sessions in Quick View here: https://convergeintl.atlassian.net/wiki/spaces/ALL/pages/154402918

Step 2: Navigate to the Clinical Review questions

If you submit a request which triggers a clinical review, you will receive an email to remind you to complete some additional questions.

Click on the ASST case hyperlink within the email (ASST-XXXXXX) which will direct you back to Phoenix.

Step 3: Complete and submit the extra sessions “Further details” questions

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.

Click “Submit”.

Next Steps

What happens next?

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?

It can take up to 5 working days for a Clinical Manager to review your request.

Then, the client’s employer has up to 7 working days to approve or decline payment.

The total time is therefore up to 12 working days.

How do I view the status of an extra sessions request?

https://convergeintl.atlassian.net/wiki/spaces/PRAC/pages/192610352