Fraud-Free Private Practice: Insurance Fraud Risks & What You Can Do Now To Avoid Them

Fraud-Free Private Practice: Insurance Fraud Risks & What You Can Do Now To Avoid Them (recorded webinar) – Online CE Course

PLEASE READ:  This course is an offsite online program by ZynnyMe.  This webinar is offered by ZynnyMe as part of their FREE community.  When you click on the “View Webinar” button below you will be redirected to the ZynnyMe site to select this pre-recorded webinar from their free library.  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.

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Fraud-Free Private Practice: Insurance Fraud Risks & What You Can Do Now To Avoid Them webinar course objectives, description, and outline

Course Objectives:

• Define fraud as it applies to billing for psychotherapy
• Identify 3 common types of insurance fraud related to coding
• Identify 3 common types of insurance fraud related to diagnosis

Course Description:

Let’s be real—billing isn’t something most therapists were formally trained in.  If you’ve been picking up tips from supervisors and colleagues, some of the billing practices you were taught are actually unethical and you may be unknowingly committing insurance fraud.  This no-shame webinar will help you spot common billing mistakes that qualify as fraud and answer your questions—the ones you’ve been afraid to ask and the ones you didn’t know to ask.

Course Outline:

1. What is the definition of fraud? Can it be accidental?
2. 6 Common Types of Insurance Fraud
   1. Billing Insurance for Missed Sessions
   2. Billing for More than Your Usual Rate
   3. Misrepresenting the CPT Code
   4. Misrepresenting the CPT Session Date
   5. Misrepresenting if Session was Telehealth vs. In-Person
   6. Misrepresenting the Provider
3. Is it Fraud to Bill for a Client who Arrives Late?
4. Proper Use of Common CPT Codes
5. Fraud Investigations: Session Times
6. Audits: When Notes May be Requested Looking For Fraud
   1. Audits Related to the Use of CPT Code 90837
7. Fraud Related to Diagnosis
8. Fraud Related to Couples Billing
9. Can I Refuse to Bill Insurance for Couples?
10. Ethical Sliding Scale Fees
11. Is it Fraud to Alter Notes Before an Audit?
12. Can I Tell Insurance Clients I Can Only See Them if They Pay Privately?
13. Is Writing Poor Notes Fraud?
14. What Can be Done to Prevent Fraud?
15. If Time / Bonus Topics:
    1. Can I Refuse to Give Superbills?
    2. Is it Fraud to Keep the Diagnosis of Adjustment Disorders After 6 Months?
    3. Network Providers: Is it Fraud to Put Your Full Fee on the Claim Form?
    4. Is it Fraud to Waive or Forgive a Client’s Copayment?
    5. Is It Fraud Not to Correct a Claim?

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

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