Keeping the Doors Open: Where Admin Meets Clinical
Integrating Clinical Best Practice & Medical Necessity to Maximize Revenue
As scrutiny from commercial insurers continues to heighten, collecting reimbursement remains a daunting and complicated pursuit. It is a more critical time than ever for behavioral healthcare providers to ensure their administrative and clinical teams are in sync. Both sides of the business must be aligned in prioritizing the quality of patient care to improve clinical outcomes and capture the insurance reimbursement necessary to keep the doors open. Medical necessity and clinical documentation drive the revenue cycle, yet sub-par documentation and medical record requests continue to present a huge challenge for most providers, often resulting in significant financial losses.
Clinicians from various corners of the industry have collaborated to present solutions for prioritizing patient care while increasing revenue. This presentation will impart a perspective of payer expectations and recent national trends, which will arm providers with a clearer understanding of the obstacles they face. In a multi-faceted discussion, presenters will dissect clinical issues that impact reimbursement, such as documentation of medical necessity, program development, and treatment implementation practices. Attendees can expect to gain insight into how clinical documentation directly impacts the entire revenue cycle, from the front-line initial authorization requests to the bitter end in appeals via medical record reviews. Best practice strategies for protecting the long-term health of your business, pertaining to both clinical and billing operations, will be discussed alongside first-hand experience from treatment providers on the practical application of these concepts.
This collaborative event is being offered by Infinity Behavioral Health Services, Elizabeth Irias, LMFT, Sober College, and Engage Therapy. We invite C-level administrators, program directors, clinical supervisors, and clinicians to learn the strategies necessary to bridge the gap between administrative and clinical team goals. Attendees will also have the opportunity to participate in a dynamic, panel-format discussion of these important issues.
A light lunch & snacks will be offered.
PRESENTED BY
Katina Gamboa, MSW
Katina is a Business Development Representative for Infinity Behavioral Health Services, a revenue cycle management company focused solely on behavioral healthcare. Following a Bachelor's Degree in Psychology from Florida Atlantic University, Katina completed her Master's Degree in Social Work at Barry University in 2010. Katina began her career as a clinician in South Florida specializing in child welfare before transitioning to substance abuse and mental health treatment. Prior to joining the Infinity team, Katina honed her business skills advancing operations for a rapidly expanding healthcare company and managing several medical practices in New York City. Katina has been recognized in both social service and medical sectors for her passion in upholding quality patient care. Her keen eye for process improvement initiatives that sustain growth and support compliance have rendered Katina a valuable asset to Infinity's west coast team.
Elizabeth Irias, LMFT #80500
Elizabeth is a licensed psychotherapist and consultant with specializations in Utilization Review and Quality Assurance, and has a private practice in Westlake Village where she provides psychotherapy to adolescents, young adults, families, and individuals with addictive disorders. She is a CAMFT-approved CE provider, and a Graduate Psychology professor at Pepperdine University in Malibu, California. Visit IriasTherapy.com to learn more about her work.
Aimee Noel, LCSW
Aimee Noel earned her Master’s degree at Smith College School for Social Work in 2002 and has been licensed since 2006. She has experience working in residential treatment, working with adults with co-occurring disorders, conducting therapy with young adults, children and families and has strong ties in the recovery community. Aimee has been the Clinical Director at Sober College for six years and has spear-headed the advancement of clinical documentation and quality assurance to strive to meet the requirements and expectations of state licensing, Joint Commission accreditation, and all of the major insurance companies.
Robert Scholz, LMFT
Robert is a Licensed Marriage and Family Therapist and Professional Clinical Counselor who has worked with adolescents, adults and families for 20 years. Robert brings expertise in the areas of addiction, men's emotional health, sports psychology, family violence and college mental health to the Engage team. Prior to his time at Engage, Robert spent a decade at Pepperdine University serving as the Assistant Director of their Counseling Center and Coordinator of their Alcohol and Drug Program. He also serves as an Adjunct Professor in Pepperdine’s Graduate School of Education and Psychology. Robert regularly conducts trainings at local and national conferences for professionals in the fields of mental health, higher education, and community corrections. He is an expert on the topic of motivational interviewing and member of the Motivational Interviewing Network of Trainers (MINT). He has co-authored several professional publications on the topics of addiction, the psychology of men and developing community partnerships to address family violence.