THIS WEBINAR HAS PASSED, BUT THE RECORDING IS AVAILABLE AT WWW.THEINSURANCEMAZE.COM/STORE
How would you feel if a health plan asked to see your notes? For most therapists, this request would bring an acute wave of anxiety, and a strong desire to protect confidentiality. Yet every day, healthcare professionals nationwide — whether in or out of network — are facing these requests, as they are being asked to provide documentation to back up their billing. Yes, even the notes of out-of-network therapists are being requested, as notes are subject to review whenever a statement/superbill is submitted to a plan.
Let’s face it — audits are stressful. While some are purely administrative, others can lead to costly claim denials or repayment requests (aka“clawbacks”). You — or your out-of-network clients — can lose thousands of dollars in unreimbursed claims.
In this webinar, we take a closer look at the reasons your notes might be requested by a health plan, how to respond if they are requested, and how to avoid these requests in the first place. We’ll also give tips on record-keeping changes you can make now, to avoid any loss of money.
- What is an audit, and how is it different than a treatment review?
- Why you might you be chosen for an audit: Key Audit Triggers
- What are the major audit triggers?
- The scary new trend: Pre-Payment and Post-Payment Audits
- What you should know about Risk-Adjustment Audits (Ciox, Inovalon, Datafied etc.)
- What are the plans looking for in an audit?
- If your notes are requested, what should you do?
- Can you refuse a records request? Can you ignore it?
- The 6 most common reasons the plan might not pay for sessions or refuse to reimburse your clients
- Documentation audits: What plans are looking for
- What’s the worst outcome if you fail a records audit
- If your notes are not great, what you can do now to get your notes in order
- If time: Avoiding fraud, and your questions about clinical reviews
BONUS FOR CALIFORNIA THERAPISTS: 2 CE credits are available for CALIFORNIA LCSWs, LMFTs, LPCCs or LEPs; COUNTS FOR LEGAL AND ETHICAL HOURS! Other licensees from California and other states should check with their licensing board for credit.
THIS WEBINAR HAS PASSED, BUT THE RECORDING AND MORE INFORMATION IS AVAILABLE AT WWW.THEINSURANCEMAZE.COM/STORE