Audits and Records Requests: What EVERY Therapist Should Know

2.5 CE credit Live Interactive Webinar Saturday, March 26th, 2022
11 am – 1:30 pm Pacific Time/2-4:30 pm Eastern Time
Presenter: Barbara Griswold, LMFT
Fee: $55

*Bonus: Free Downloadable Audit Tool For All Participants

For those who register but are unable to attend, CE credits (though not Live) will be available by viewing the recording and completing the post-test and evaluation.

Tokens may not be used with webinars.

This webinar satisfies requirements for live interactive CE credits for all professions.

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For most therapists, the idea of a health plan asking for session notes brings an acute wave of anxiety, and a strong desire to protect confidentiality. Yet every day, healthcare professionals nationwide are being asked to provide documentation for a variety of reasons. Even the notes of out-of-network therapists are being requested, as they are subject to review when a client seeks reimbursement from a plan.

While some audits are purely administrative, others can lead to costly claim denials or repayment requests (“clawbacks”). You may lose thousands of dollars in unreimbursed claims, or your out-of-network clients can have their reimbursements denied.

In this webinar, we’ll examine why your notes might be requested by a health plan, how to respond if they are requested, and how to avoid these requests. We’ll also give tips on record-keeping changes you can make now, to avoid any loss of income.

Topics include:

  • What is an audit, and how is it different than a treatment review?
  • Why you might you be chosen for an audit
  • The scary new trend: Pre-Payment and Post-Payment Audits
  • What you should know about Risk-Adjustment Audits (Ciox, Inovalon, etc.)
  • What are the plans looking for in an audit?
  • If your notes are requested, what should you do?
  • 6 reasons the plan might not pay for sessions
  • What can happen if you fail an audit?
  • What you can do now to get your notes in order?

Plus, you’ll get a downloadable Health Plan Sample Audit Tool to ensure your charts meet documentation standards. 

For those who register but are unable to attend, CE credits (though not Live) will be available by viewing the recording and completing the post-test and evaluation.

Target audience: This course is appropriate for all mental health professionals

Content level: Introductory-Intermediate

 

Barbara Griswold, LMFT is the 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.

 

Learning objectives:

  • After attending this webinar, participants will be able to
  • Identify the 4 most common reasons that records might be requested by a health plan
  • Identify 11 common health plan documentation requirements
  • Identify the difference between progress notes and psychotherapy notes
  • Identify one ethical way to add information to records without altering session notes

Outline:

  • Who should worry about audits
  • The 4 types of records requests / audits, and how they are different from clinical reviews
  • The purposes of each type of request, and what the plan is looking for
  • Sample letters you’ll receive
  • 4 common audit triggers
  • Altering / adding things to records after the fact
  • What to do if you get a request for records
  • What should be in your documentation
  • Clawbacks — can they ask for money back?
  • Appealing a refund request
  • The bright side of audits

Webinar interaction & system requirements

This live webinar is fully interactive. Attendees may ask and answer questions throughout the presentation and participate in instructor-led polls.

To be eligible for Live CE credits, you must be logged in the entire time. Entry to the webinar will be closed 5 minutes after the scheduled start time.

 This webinar will be hosted through Zoom. Upon registration, participants will be emailed a link directly from Zoom that you must use to access  the live webinar from any desktop, laptop, tablet, or smart device. The webinar will open 10 minutes prior to start time. It is recommended that you join early to give yourself time to troubleshoot potential connection problems.

Fee $55

Tokens may not be used with webinars.

Course completion & CE info

Course completion requirements: Shortly after the end of the webinar,  a link will be sent to the email address you used to register.  This link  directs you to a site where you can add the webinar course to your Zur Institute account (if you do not have an account, instructions will be provided on how to create one).  After adding the course, you will be able to view the webinar recording and handouts, complete the posttest and evaluation, and download your CE certificate.  For those wanting to review the recording of the webinar, it will be available within  five days of the webinar.

In order to receive Live CE credit hours, you must attend the entire webinar and then complete the post webinar test and evaluation within 30 days of the end of the webinar.

If you pay and either miss part of the webinar or are unable to attend: Don’t worry. You can still obtain CE credits (though not Live) by viewing the recording and taking the post-test and evaluation. You will receive an email notification when the recording is ready for viewing, no later than 5 days after the webinar is over.  You have 3 years to complete a home-study course.

Our Live Webinars are live and include ample opportunity to interact with the presenters. They qualify as in-person continuing education in most states. Each state has its own requirements for licensure, including continuing education requirements, to maintain licensure. Questions about CE requirements for state licensure should be directed to your state board.

Live CEs will be available for all professions.

CE credits for psychologists will be provided by Sacramento Center for Psychotherapy who is co-sponsoring this webinar. Sacramento Center for Psychotherapy is approved to provide Live CE credits by the American Psychological Association.  

CE credits for all other professions including New York licensed psychologists, will be provided by Zur Institute.  (this remains for webinars co-sponsored by Sacramento Center for Psychotherapy, but none of the others, including this one)

Zur Institute has been approved to provide Live CE credits by the following boards:

California Psychologists: Zur Institute (ZUR001) is approved by the California Psychological Associationto provide continuing professional education for psychologists.  Zur Institute maintains responsibility for this program and its contents.

Zur Institute has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7144. Programs that do not qualify for NBCC credit are clearly identified. Zur Institute is solely responsible for all aspects of the programs.

New York Psychologists: Zur Institute is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0029.

New York Licensed Psychoanalysts (LPsyAns): Zur Institute is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed psychoanalysts #P-0049.

New York Social Workers (LMSWs & LCSWs): Zur Institute SW CPE is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #0081.

New York Marriage and Family Therapists (LMFTs): Zur Institute is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for Licensed Marriage and Family Therapists. #MFT-0006.

New York Mental Health Counselors (LMHCs): Zur Institute is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for Licensed Mental Health Counselors. #MHC-0007.

Social Workers: Zur Institute, provider #1113, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Zur Institute maintains responsibility for these courses. ACE provider approval period: 6/1/2021-6/1/2024.

 

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