|Seminar: Special Investigations Unit (SIU) - What to Know in a Commercial Payer Audit|
When: November 8, 2017 at 10:30 AM - 2:00 PM Eastern Time
Where: Infinity Offices, Fort Lauderdale, FL
Pricing: $75 for Non-Members / $50 for AATA Members
Register by phone at (888) 958-2282
Join the American Addiction Treatment Association, Nelson Hardiman, and Infinity Behavioral Health Services on November 8th
For the: "Special Investigations Unit (SIU): What to Know in a Commercial Payer Audit" Seminar
What's your reaction when you hear the word AUDIT?
It's the one word that can send staff into a panic.
No one likes an audit but comprehensive reviews are becoming common in the addiction treatment and recovery industry. With heightened attention toward billing practices, providers need to be proactive in preventing and eliminating accusations of fraud or abuse.
Most large insurance companies have special investigations units (SIU) that routinely identify, investigate, and expose fraudulent practices. There are best practices to handle an audit that will benefit your recovery program or addiction treatment center. There are also best practices to avoid being audited.
Why is a provider the target of an investigation? Red-flagged!
There are red flags for fraud detection as the SIU's are employed to look for anything that resembles fraudulent practices. One red flag can trigger an investigation or audit, which results in a full review of a provider's insurance methods, billing practices, referrals, marketing practices, medical and billing records, spreadsheets, claim information, and supporting documentation. Enforcement actions may result from an investigation by the SIU. That can include freezing all payments until the investigation is complete, accusations of fraud, or a court case.
Any provider billing an insurance company runs the risk of an audit, which can have severe consequences for both finances and workflow. As the behavioral health field expands to better meet the needs of a national addiction crisis, payers are putting more attention on the industry, and subjecting providers to significantly more scrutiny.
This seminar, cosponsored by Infinity Behavioral Health Services, Nelson Hardiman, and AATA, will give an overview of the commercial payer SIU process, provide lessons learned for surviving an audit, and offer some tips for how to avoid being flagged in the first place.
Industry experts will walk you through an audit from start to finish and go through the possible outcomes. They will also discuss the issues most frequently addressed by payers, how to address them in an audit, and how to make the changes to your practice today to lower the chance of being audited.
Avoid an audit and stay informed!*NOTE: Members must be logged into the AATA website for discount pricing.
Register by phone at (888) 958-2282
Lisa Montague informs her healthcare practice with the transactional know-how of assisting public and private clients with strategizing, organizing, documenting, and closing complex financing deals for large-scale infrastructure and energy projects in multiple states.
As a member of Nelson Hardiman's Transactional and Compliance practice groups, Lisa represents healthcare providers, including hospitals, physician organizations, long-term and behavioral care providers, telemedicine providers, and other healthcare-related organizations, in transactions and regulatory matters. Her practice focuses on general corporate and healthcare regulatory matters in connection with mergers and acquisitions, joint ventures, affiliations and dispositions of companies in the health care services industry.
Max Sirianni is General Counsel and Chief Compliance Officer for Infinity Behavioral Health Services. As in-house counsel for Infinity, Max provides comprehensive internal representation for Infinity including keeping Infinity ahead of an ever-changing legal landscape for behavioral healthcare, developing strategic partnerships for growth, and directing activities to limit risk and maintain compliance. Max graduated from Georgetown University Law School in 2013, and is admitted to practice in Florida and Colorado. Prior to his position at Infinity, Max worked as a Public Defender in Colorado where he represented defendants in many jury trials and hundreds of contested judicial hearings.
Lee Arian is a former Assistant United States Attorney and current Partner at Nelson Hardiman. Lee has dedicated his career fighting for integrity within the American healthcare system. He spent nearly eight years in the U.S. Attorney's Office's Criminal Division Public Corruption and Government Fraud section where he served as the health care fraud coordinator, investigating and prosecuting fraud involving health care, as well as fraud against other government programs, banks, securities and taxes. Sixteen years of litigation and government enforcement experience in both criminal and civil cases has positioned him as a prominent thought leader among Fortune 50 companies. He also served as Vice President for Optum's advisory services team and as Staff Vice President at Anthem, where he oversaw the enterprise fraud and abuse audit efforts, implementing cutting edge tools to ensure regulatory compliance with all federal and state laws relating to recovery. Lee graduated magna cum laude from Georgetown University and earned a Juris Doctor degree from UCLA School of Law
Nelson Hardiman represents healthcare providers, including hospitals, physician organizations, long-term and behavioral care providers, and other healthcare-related organizations, in business litigation, transactions, and regulatory matters. Although we are based in California, our attorneys are routinely asked to advise business organizations that are national in scope. For more than 20 years, our lawyers have focused on regulatory compliance, litigation, and transactions specific to the healthcare industry. We combine specialized experience in a wide range of healthcare sectors with a proactive and attentive approach, making us the most effective choice for healthcare legal matters.
Since 2011, Infinity Behavioral Health Services has been providing unparalleled revenue cycle management services to behavioral healthcare providers. As a result of our operational experience, we deeply understand the day-to-day issues that arise in attempting to navigate managed care companies. Our goal is to help you enhance your quality of service, while increasing revenue and maintaining compliance with industry and managed care standards.