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Skills and Strategies for Leveling the Utilization Review Playing Field

Join Beth as she presents at the Cape Code Symposium on Addictive Disorders in Hyannis, MA!

Presentation Details:
Between the years of 1999 and 2016,  the rate of drug overdose deaths tripled in the United States (CDC, 2017), and the national suicide rate increased 28% (NIMH, 2018).  Thousands are in need of appropriate and medically-necessary mental health treatment, and insurance authorizations are part of this equation… lives depend on our client advocacy skills.  Join Elizabeth Irias, LMFT, a guru in Utilization Review, for an engaging presentation that provides critical strategies to improve concurrent review outcomes in an ethically- and legally-sound manner.  As a result of implementing the methods Elizabeth presents, providers report an improvement in the length of treatment authorizations by 15% to 20%, as well as improvements in overall clinical documentation quality and auditing outcomes.  This presentation offers key information about managed care systems and Utilization Review-related laws, including the effect of clinical documentation on auditing results ("If it's not in the chart, it didn't happen.") and sentinel incident or legal investigations. Join this presentation to sharpen your skills and better help your clients in need.

Learning Objectives:

Upon completion of this course, participants will be able to:

  1. Provide one or more definitions for the term ‘Medical Necessity’

  2. Demonstrate how to effectively use insurance Level of Care Guidelines during UR calls

  3. Outline three or more concurrent review strategies for improving UR outcomes

Target Audience: Admissions Professionals, Utilization Review Professionals, Clinical Managers, Physicians, Nurses, Social Workers, Psychologists, Mental Health Counselors, Private Practitioners, Alcohol/Drug Educators, Marriage & Family Therapists, Professional Counselors, Chemical Dependency Counselors, Rehabilitation Counselors, Alcoholism and Drug Abuse Counselors, Family Physicians, Nurse Practitioners, Physician’s Assistants

To learn more about the event, visit https://www.ccsad.com/