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Insurance Billing and Reimbursement Complications Within the Addiction Recovery

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Insurance companies are increasingly conducting reviews of behavioral health and substance abuse treatment program providers and are looking for cases of fraud and abuse. Their special investigation units are demanding the recoupment of fees paid to such programs based on lack of licensure, certification, and accreditation, questions regarding the appropriateness of claims, and questions regarding the adequacy of documentation for clinical services.

What are the key issues insurance companies are raising to demand recoupment of fees from substance abuse treatment programs? What can programs do to prevent such inquiries?

In this webinar, you will learn:
  • recent trends
  • the reimbursement minefield
  • practices that raise the risk of claims of fraud & abuse
  • understanding insurance companies' fraud & abuse arguments
  • risks related to the substance of a claim
  • risks related to the billing of a claim fraud and abuse - payor concerns
  • ​pre-authorization/verification of benefits
  • ​billing and coding challenges on the horizon
  • and strategies for reducing risk
Harry Nelson, Nelson Hardiman

This is a basic-level webinar.

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