Dealing with Insurance: How Auditors Think and Why

Course Materials

Syllabus

  1. The Concept of Medical Necessity
    • Definitions and uses by insurance
    • The importance of good clinical assessment
    • Documentation via the “Clinical Loop”
  2. Insurance and Client Access
    • What “informed consent” really means
    • Common myths and mistakes
    • The progress dilemma
  3. How to self-audit client files
    • Red flags for audits
    • Important criteria to include
    • Exercise: Review a note using a sample audit form
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