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 should check with their licensing board for credit. Complete CE information is in the Q&A section below.
- Option 1: Join us live Saturday, August 28, 2021:
- 11 am – 1 pm Pacific / 12 pm – 2 pm Mountain / 1 pm – 3 pm Central / 2 pm – 4 pm Eastern
- All registrants will automatically receive the recording link after the webinar, in case your plans change
- Option 2: Watch at your convenience! Register and the link to the webinar recording will be sent to you within 6 hours after the webinar. All registrants will automatically receive this link — there is no need to request it. Recording is available for one year. CEs are available even if you just listen to the recording — instructions will be given when the link is sent.
- $45.00 for licensed therapists/billers, NO CE credits desired
- $55.00 for licensed therapists/billers, 2 CE credits desired (NOTE: CE approval guaranteed only for California BBS Licensees, other licensees will have to check with your licensing board for credit. Complete CE info is below)
- $25.00 for therapists who have not yet earned a license (your honesty is appreciated)
- $35.00 each for groups of 4 or more, NO CE credits desired
- $45.00 each for groups of 4 or more, CE credits desired
After registering, you will be sent EventBrite tickets (you may ignore) and invoice, and usually within one day, you will get a confirmation from Zoom. All attendees will receive email reminders with your link from Zoom one week, one day, and one hour before the event with the webinar link. This link is unique to you — please do not share it.
All registrants will get the link to the recording within 6 hours after the webinar, to watch or review at your convenience.
TO PURCHASE TICKETS: CLICK HERE
PRESENTER: Barbara Griswold, LMFT is author of Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance – And Whether You Should, now in its 8th edition. In addition to her private practice in San Jose, CA, she provides consultations and trainings about insurance, progress notes, and practice-building to therapists nationwide. She invites you to contact her at theinsurancemaze.com/contact.
Questions and Answers:
Who should attend? This event is designed for all types of mental health professionals nationwide, whether they work for insurance or not.
How do I get CEs for this event? You must purchase the ticket option that includes CEs. After the webinar, if you have registered for CEs you will be emailed a link to the post-test and evaluation, even if you did not attend live. You may get CEs whether you join live or listen to the recording. Course completion certificates will be emailed immediately after completing the evaluation and passing the post-test with a minimum 70% score. Post test answer keys will not be sent. Barbara Griswold LMFT (CAMFT CE provider #023504) is approved by the California Association of Marriage and Family Therapists to provide Continuing Education for California LMFTs, LCSWs, LPCCs, and/or LEPs. Others should check with their licensing boards for possible credit. Barbara Griswold maintains responsibility for this course and its content. For complete CE policies, click here
Who can I contact with questions? For any questions, concerns, or grievances related to this webinar or registration, please contact Barbara Griswold, LMFT via email at firstname.lastname@example.org. Any person with disabilities who may require accommodations to participate in our trainings or special events is asked to please contact us at least 7 days in advance.
What’s the refund policy? All fees paid are non-refundable, except in cases of duplicate registration or errors in registration.
TO PURCHASE TICKETS: CLICK HERE