Getting Paid and Staying Out of Trouble – Building an Effective Risk Management Program

When: May 22, 2018 at 11:00 am – 2:00 pm PST
Where: Nelson Hardiman Conference Facilities, West Los Angeles

In the addiction treatment industry, we too often disregard matters of regulatory compliance and risk management until it’s too late. This can result in legal liability – including fines and penalties – as well as costly payor disputes, which impact your financial viability. When we deal with these issues, it’s often while on the defensive and solely on a “reactive” basis. Ultimately this approach to compliance and risk will cost you time and money.

In this seminar, we’ll teach you how to take a more “proactive” approach to these threats to your business and ability to deliver care. We’ll show you a step-by-step process to implement and maintain a robust compliance and risk management program for your organization in a way that’s efficient and cost-effective.

In the first part of this seminar, we will cover some of the top risk areas for addiction treatment providers, including:

1. Billing and Reimbursement Concerns
2. Provider-Payor Disputes
3. Utilization Management and Medical Necessity
4. Patient Financial Responsibility
5. Procurement of Coverage
6. Payor Audits

And More!

In the second part of the seminar, we’ll show you a system that will allow you to take the initiative and preemptively avoid risk and compliance concerns by creating a customized risk management plan for your addiction treatment provider organization, including:

1. How to Build Robust Policies and Procedures
2. How to Provide Effective Education and Training
3. How to Conduct Practical Internal Assessments
4. How to Effectively Monitor and Resolve Client Complaints and Concerns
5. How to Impactfully Manage Your Staff Through Feedback, Performance Reviews, and Disciplinary Guidelines
6. How to Successfully Respond to Possible Compliance Violations and Create Plans of Correction that Will Mitigate Your Liability

Most important, we will show you the best ways to effectively document your attention to compliance and risk in a way that will allow you to use your risk management program as both a sword – to improve your organization’s business model and quality of care, as well as a shield – to use as a defense to audits and lawsuits that threaten your financial viability.

Presenters

Nick Merkin is the Chief Executive Officer of Compliagent, a national healthcare compliance consulting firm based in Los Angeles. As part of his consulting practice, he frequently serves as a fractional or interim Chief Compliance Officer for addiction treatment providers experiencing rapid growth, payment challenges, or in the process of merger or acquisition.

Elizabeth Irias, licensed psychotherapist, is a guru in the areas of behavioral health Utilization Review and Clinical Documentation. She trains companies throughout the United States how to legally and ethically improve their Utilization Review outcomes and clinical documentation processes, with the added benefit of reducing liability risks.

Kathryn F. Edgerton is a transactional and regulatory attorney with Nelson Hardiman. Ms. Edgerton has built a significant practice advising hospitals, physician organizations, addiction treatment and behavioral care providers, long-term health providers, telemedicine providers, home health providers, medical spas, and other health-related organizations on the complex transactional and regulatory issues impacting the healthcare industry.