Insurance Claims: Empowering Your Clients for Coverage

This program is presented in partnership between The Chicago School of Professional Psychology, The Kennedy Forum of Illinois, and the Austin Riggs Center.

Program Description:

Presented by Joe Feldman, MBA,  Partick Kennedy, Eric Plakun, MD., and Marie Casciari, JD.

This program, when attended in its’ entirety, offers 1.0 CEs for Psychologists, 1.0 CEUs for Illinois state counselors and Social Workers, and 1.0 BBS California CEUs for LMFTs, LPCCs, and LCSWs.

Insurance coverage for mental health and substance use treatment has long been a challenge compared to coverage for physical health.  While federal and state laws have been implemented over the last several years to require parity treatment (i.e., mental health same as physical health), it remains far too common that claims are denied and coverage is out-of-reach for individuals requiring such care.  More recently, federal lawsuits have been won in favor of patients where insurers improperly, that is illegally, denied claims.  Step-by-step, the landscape may be shifting so that patients will be less likely to confront denied claims.  But we’re not there yet.

Insurers have denied claims for “lack of medical necessity” where that determination has been made independently of the patient’s treating clinician.  Such denials may be confounding to both patients and to their clinicians.  After all, who should be making the determination about whether care is indeed “medically necessary.”

Authors of a recently published article will describe their recommendation for clinicians to provide a “letter of medical necessity” to their patients as a tool to improve the likelihood that insurers timely approve claims.  Such letters have proven crucial in lawsuits and appeals; they represent an important tool that clinicians can provide their patients.

Learning Objectives

After attending this workship participants will be able to:

1. Identify the key principals of the insurance parity laws regarding mental health and substance use treatment.

2. Describe the landmark Wit dcision’s reinforcement of expectations for insurers’ compliance with parity

3. Author medical necessity letters to help their patients with insurance coverage for mental health and addiction related treatmen

Registration and Fees:

This program is free to attend.

CE/CEU Certifcate: $10.00*

*CE/CEU Certificate available without charge for TCSPP Facutly/Staff/Students.

Refund Policy:

100% of tuition is refundable up to 48 hours before the program.