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
Join the American Addiction Treatment Association, Nelson Hardiman, and Infinity Behavioral Health Services on November 8th for "Special Investigations Unit (SIU): What to Know in a Commercial Payer Audit.”
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, co-sponsored 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 be informed!
*NOTE: Members must be logged into the AATA website for discount pricing.