Audits and Records Request Webinar (Recorded Webinar) – Online CE Course
PLEASE READ: This course is an offsite online program by ZynnyMe and has a separate cost in addition to the units purchased with Aspira CE. This webinar is offered by ZynnyMe as part of their paid community. When you click on the “View Webinar” button below you will be redirected to the ZynnyMe site to enroll and pay for their Business School For Therapists program. As a paid subscriber with ZynnyMe, you will then have access to this webinar. After completing the webinar you can then return to this site (aspirace.com) to complete the exam for this course, pay for your units, and earn your certificate of completion for CE.
Want to build your business and get CEUs at the same time? Business School for Therapists is the largest online business training program for therapists, counselors, social workers and psychologists. (See 8 of the 9 modules for Business School for Therapists in our course list).
Audits and Records Request Webinar Course Objectives, Description, and Outline
- Identify the most common reasons that records might be requested by a health plan
- Identify what health plans look for in documentation reviews
- Identify the difference between progress notes and psychotherapy notes
- Identify an ethical way to add information to records without altering notes
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 live 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.
- Who needs to worry about audits, and why
- Types of insurance audits
- Clinical reviews (not an audit)
- Administrative audits
- Claim audits
- Sample insurance plan letters requesting records
- Treatment record requests
- What the plan wants to see
- Risk adjustment audits
- Progress vs. psychotherapy notes
- Claim-Related Audits
- What insurance plans look for in your documentation
- Common audit triggers
- The 90837 CPT code dilemma
- Altering records
- Responding to records requests
- What should be in your progress notes
- If time:
- Do you need a release?
- Appealing a denial or request for repayment
Instructors: Barbara Griswold, LMFT
Barbara Griswold, LMFT and author of Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance – And Whether You Should, now in its 8th edition. She has been interviewed on NPR’s Morning Edition and served 2 years on the Ethics Committee for the California Association of Marriage and Family Therapists. In addition to her 31-year private practice in San Jose, CA, she provides individual consultations, Continuing Education webinars, and group trainings to therapists nationwide, on topics including insurance, progress notes, and practice-building. She invites Zynnyme members to check out all the resources on her website at theinsurancemaze.com.
Click here to return to Aspira Continuing Education’s Home page of CEs for Psychologists, MFTs, Social Workers, Professional Counselors, and SUDC Counselors
You may also be interested in:
What’s Missing From Your Charts: Writing Great Progress Notes