When: September 7, 2018 at 10:00 am – 1:00 pm CST
Where: Lin and Patel Conference Facilities, Chicago
There are best practices to handle an audit that will benefit your recovery program or addiction treatment center. There are also best practices to avoid being audited.
There are red flags for fraud detection as the payers employ investigators to look for anything that resembles fraudulent practices. One red flag can trigger an investigation or audit, which results in a full review of a provider’s insurance methods, billing practices, referrals, marketing practices, medical and billing records, spreadsheets, claim information, and supporting documentation. Enforcement actions may result from an investigation by the SIU. That can include freezing all payments until the investigation is complete, accusations of fraud, or a court case.
Audits can have severe consequences for both finances and workflow. As the behavioral health field expands to better meet the needs of a national addiction crisis, payers are putting more attention on the industry, and subjecting providers to significantly more scrutiny.
This workshop, co-sponsored by Infinity Behavioral Health Services, Lin and Patel LLC, Nelson Hardiman, and BHAP, will provide lessons learned for surviving an audit, offer some tips for how to avoid being flagged in the first place, and give an overview of the commercial payer SIU process.
Some of the workshop’s highlights:
- Identifying Major Risk Factors
- Documentation Issues
- Billing Issues
- Patient Responsibility
- Laboratory Services
- Marketing/Kick-Back Issues
- Common Payer Issues
Industry experts will discuss the issues most frequently addressed by payers, how to address them in an audit, and how to make the changes to your practice today to lower the chance of being audited.