Don’t Risk Your Behavior Health Revenue: Meet Payer Documentation Requirements

Learn about Multiple Types of Behavioral Health Encounters and Documentation Elements for Reimbursement

Behavioral health challenges are frequently identified in primary care or emergency center encounters. Clear documentation of the revealed information will be critical in supporting the medical necessity of follow up activities. Was an event witnessed? Was the patient or other endangered? What are the likelihood of patient compliance with treatment recommendations? How will the behavior affect management of medical problems?

Auditing for billing and coding accuracy is increasing from multiple sources. Regardless of how the claim is submitted, documentation will be the primary deciding factor in whether the record adequately supports the claim data. Delays and denials are costly. Records requests are increasing in frequency. When deficits are identified, reimbursement may be recovered and providers may be placed under unpleasant and time-consuming scrutiny.

Join this session, where auditing and training expert Dorothy D. Steed will review multiple types of behavioral health encounters and documentation elements that payers seek to justify your reimbursement.

You will understand payer documentation requirements for your patient encounters. You will be able to create an effective appeal for the denied claims. Further, the session will also help you understand the billing patterns that may trigger an audit and how payers determine questionable reporting.

Session Highlights

This program will cover:

• Expectations of the examination documentation for physicians who submit evaluation and management codes
• Family therapy
• Substance abuse coding hierarchy
• Diagnosis coding and medical necessity of services
• Medical and behavior health and patient non-compliance
• High-risk psychosocial situations
• Posttraumatic Stress Disorder (PTSD) and other stressors that may require additional coding

Session Agenda

• Clinical documentation improvement
• General behavioral health documentation requirements
• Mental health and substance abuse
• Electronic health records
• Self-audits – an added layer of protection

Who Should Attend

• Primary care and behavior health providers
• Billers and coders
• Finance and revenue cycle staff
• Nurses and social workers
• Education and legal professionals

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