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Insurance Client Advocacy: Utilization Review Skills & Strategies
Many providers are unfamiliar with the policies and procedures at insurance companies, as well as the regulations that impact Utilization Review proceedings, and this leaves clinicians at a distinct disadvantage when advocating for insurance authorization. When treatment ends abruptly due to premature authorization request denials, clients are left without appropriate mental healthcare, contributing to diminished treatment gains and symptom relapse. This engaging presentation provides critical guidance about improving utilization review outcomes in an ethically- and legally-sound manner. In this session, attendees will learn about medical necessity, important laws and standards of care that affect clinical documentation and managed care processes, and easy-to-integrate strategies to better advocate for clients with their insurance companies. 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.

Jul 15, 2020 01:00 PM in Eastern Time (US and Canada)

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Speakers

Elizabeth Irias, MS, LMFT
President & Founder @Clearly Clinical
Elizabeth Irias, MS, LMFT is a licensed Marriage and Family Therapist with specializations in Utilization Review and Quality Assurance, and also the founder of Clearly Clinical, an online behavioral health Continuing Education program. As a consultant and trainer, Beth works closely with clinical teams across the country to improve their quality of care, documentation practices, and utilization review outcomes using her copyrighted methods. She is an adjunct faculty member at Pepperdine University in Malibu, CA, in the graduate psychology department, and she regularly presents at conferences and seminars throughout the US. She also operates a private practice in Westlake Village, CA, where she provides therapy to adolescent/young adult clients, members of the LGBT population, and those with addictive disorders.