Insurance Documentation for Therapists: How Auditors Think

Presented by Maelisa Hall, PsyD on 08-23-2019 at 9 a.m. Pacific (noon Eastern) to 11 a.m. Pacific (2 p.m. Eastern)

As access to insurance increases, the hope is that access to psychotherapy will also increase, whether provided in or out of network. However, mental health professionals receive little to no training in how insurance standards or requirements impact their care for people. This is especially true for clinical documentation and approval of services by insurance companies. 

Insurance companies value the concept of “medical necessity” and it is crucial for both in-network and out-of-network clinicians to understand this concept. Documentation is the means by which clinicians justify medical necessity. Ethical and meaningful documentation can serve as a valuable tool when interacting with insurance companies during an audit or advocating approval of mental health services.

Along with feelings of apprehension, there are many myths that clinicians commonly believe about insurance audits and clinical documentation. Insurance companies have specific requirements for documentation, but these requirements are actually easy to understand and can be mastered by mental health professionals. This web conference will provide the “behind the scenes” reasoning for most insurance documentation standards, as well as practical strategies for simplifying the process of writing notes and treatment plans that satisfy these standards.  

In this 2-hour continuing education web conference, Maelisa Hall, PsyD will explain what she has learned in her experience reviewing clinical charts objectively as an auditor. Dr. Hall will discuss what is commonly missed or misunderstood by mental health professionals in their documentation. In this interactive workshop, clinicians can learn how to correct these actions and gain the confidence they need to provide quality mental health care with less stress in their administrative tasks.

This introductory instructional level web conference is designed to help clinicians:

  1. Recognize how clinical documentation can assist or deter people from receiving reimbursement from insurance for mental health services.
  2. Apply the concept of medical necessity to documentation throughout treatment.
  3. Explain how to use medical necessity with various forms of treatment and different populations.
  4. Describe how to advocate for people in their care during an insurance audit.
  5. Practice the process of reviewing a progress note based on both professional ethics and insurance standards.

Statement of program's accuracy, utility, and risks: The contents of this program are based primarily on the ethics codes of these professional organizations: AAMFT, ACA, APA, NASW, NBCC. Contents are also guided by commonalities in state law and commonalities in published medical necessity criteria from various insurance companies in the United States. Some interpretation and analysis presented is made by the presenter, in consultation with knowledgeable colleagues and expert consultants. Statements about approval or denial of services are according to presenter’s understanding of medical necessity and clinical documentation standards at the time of the program. The presenter may not know how to apply all principles discussed to every situation or person. This program discusses strategies for complying with ethical responsibilities for documentation and advocacy according to the above listed ethics codes. It may not include information on all applicable state laws. Misapplication of the materials, or errors in the materials, could result in denial of payment, denial of mental health services, or non-compliance with applicable laws or ethics codes.

Declaration of conflicts of interest and commercial support: None.

If you have any questions, please contact us here.

Continuing Education (CE) Information

2 CE contact hours will be provided by GoodTherapy for attending this web conference in its entirety.

GoodTherapy is an Approved Education Provider by NAADAC, The Association for Addiction Professionals (provider #135463). Of the eight counselor skill groups ascribed to by NAADAC, this course is classified within Counseling Services. 

GoodTherapy is an NBCC-Approved Continuing Education Provider (ACEPTM) and may offer NBCC-approved clock hours for events that meet NBCC requirements.

This organization, GoodTherapy, provider #1352, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org through the Approved Continuing Education (ACE) Program. GoodTherapy.org maintains responsibility for the program. ASWB Approval Period: 03/30/2019 - 03/30/2022. Social workers should contact their regulatory board to determine course approval for continuing education credits. Social workers participating in this course will receive 2 clinical continuing education clock hours. 

GoodTherapy is approved by the American Psychological Association to sponsor continuing education for psychologists. GoodTherapy maintains responsibility for this program and its content. GoodTherapy.org received APA approval in May 2011. Events after 2011 may meet APA requirements for Continuing Education credits.

GoodTherapy.org, LLC 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 #SW-0395.

GoodTherapy, LLC 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-0022 and for licensed mental health counselors #MHC-0031.

Registration Information

Premium and Pro Membership with GoodTherapy includes access to this web conference at no additional cost. Not yet a member? Sign up for a Premium or Pro Membership here.

Mental health professionals who are not members can attend this live web conference for $29.95 or access the homestudy recording for $14.95. Sign up here to purchase this CE course and earn a CE certificate.

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Meet the Presenter

Maelisa Hall, PsyD

Maelisa Hall, PsyD

Maelisa Hall, PsyD is a licensed clinical psychologist and the owner of QA Prep, where she offers online trainings for mental health professionals in all things documentation and ethics. Dr. Hall does most things online and has become a serial entrepreneur after discovering a love for online marketing.

Training is Dr. Hall’s true passion. She loves to help therapists connect meaning to the typically mundane task of paperwork. She encourages professionals to consider why they are creating policies or doing things, rather than copying from others or repeating what they have heard in the past. 

In Dr. Hall’s continuing education web conference for GoodTherapy, she will be providing strategies for making notes more meaningful in daily practice, while also examining the common fears, misconceptions, ethical guidelines, and risks associated with documenting for insurance. Get ready for practical but thought-provoking strategies and prepare for a lively discussion where multiple points of view are accepted.

Continuing Education Provider Approvals

  • aceGoodTherapy.org is Approved by the American Psychological Association to sponsor continuing education for psychologists. GoodTherapy.org maintains responsibility for this program and its content. GoodTherapy.org received APA approval in May 2011. Events after 2011 may meet APA requirements for Continuing Education credits.
  • Logo GoodTherapy.org has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6380. Programs that do not qualify for NBCC credit are clearly identified. GoodTherapy.org is solely responsible for all aspects of the programs.
  • Logo This course has been approved by GoodTherapy.org, as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #135463. GoodTherapy.org is responsible for all aspects of their programming.
  • aceGoodTherapy.org, provider #1352, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org through the Approved Continuing Education (ACE) Program. GoodTherapy.org maintains responsibility for the program. ASWB Approval Period: 03/30/2019 - 03/30/2022. Social workers should contact their regulatory board to determine course approval for continuing education credits. Social workers participating in this course will receive 2 clinical continuing education clock hours.
  • GoodTherapy.org, LLC 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 #SW-0395.
  • GoodTherapy.org, LLC 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-0022 and for licensed mental health counselors #MHC-0031.
  • Person Centered Tech, LLC is approved by the American Psychological Association to sponsor continuing education for psychologists. Person Centered Tech, LLC maintains responsibility for this program and its content.

620 CE hours and counting!

All are available to GoodTherapy Premium or Pro Members at no additional cost.
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