The Therapist Collective

Avoiding Audit or How to Sleep Better at Night

This is a guest blog contributed by Chris and Joe Elwart, psychotherapists (recently retired) and coaches and co-owners of PSS Billing Service. Chris and Joe specialize in medical billing for psychotherapists. They are our newest sponsors as well as “People You Must Know” for any billing or audit questions. Please enjoy this guest blog, and please hold October 11th, 4-6 pm for Chris and Joe’s presentation on Avoiding Audit. Details coming in the next few weeks.

Your job is to help people and that is what you love doing, right?  You want to make a difference in the world and the lives of people because you care…deeply.  After all, you went to school for a long time and at great expense to acquire a license so that you could serve others in a meaningful and caring way.

You may be under the impression that you are being paid by insurance companies to do just that.  Ha!

What you may not know is that you are not being paid by insurance companies for services rendered, but for the notes for those services – in other words, you are being evaluated and paid based on the notes you are taking, not on your patient care and effectiveness!

Many, if not most local therapists, have received the dreaded email:

“To Ms. Smith, we are conducting a routine audit and are requesting your medical records for patient X from January 1, 2018 to January 1, 2019 to be remitted to our office thirty days from the receipt of this letter. Please provide the following information:

-Complete copies of office visit notes from Jan. 1, 2018 to present

-Hospital intake/ Discharge summary

-All test result findings

-Treatment plan

-Medical records and list of medication

-Confirmation of medical necessity for treatment”

A million thoughts race through your brain: What exactly are they looking for?  What are the consequences if you do not pass the audit? How can you be informed and wise in this situation?

These questions and many more will be addressed in the October 11th presentation. Specifically, we will discuss:

1. 17 points that insurance companies look for in an audit;

2. Key elements in the intake;

 3. Critical points to include in every note;

4. How to beat them at their own game and have fun doing it!

Please join us to learn what you can do to not only pass an audit with flying colors, but how to fly beneath the radar of the auditors.