Insurance Client Advocacy: Utilization Review Skills & Strategies
Автор: C4 Recovery Foundation
Загружено: 2020-07-15
Просмотров: 3283
Описание: 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.
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