Are You Ready for An Audit?

Diagnosing, Documenting, Billing and Coding in Private Practice

5 Ethics CEUs

Are You Ready for An Audit? Diagnosing, Documenting, Billing and Coding in Private Practice, Course #3491 is approved by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program to be offered by Leslie S. Tsukroff, MSW, LCSW as an individual course. Individual courses, not providers, are approved at the course level. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. ACE course approval period: from 02/12/21 to 02/12/2023. Social workers completing this course receive 5 ethics continuing education credits.

Approved Delivery Method and Format: In-person Workshop and Distance learning Live Webinar

Join New Jersey’s premier ethics consultant Leslie S. Tsukroff, MSW, LCSW for an informative and interactive workshop in which participants will leave this workshop being able to:

  • Identify fraudulent practices around billing, coding diagnosing and related clinical/billing documentation

  • Outline key elements of avoiding fraudulent billing, diagnosing and related

  • clinical/billing documentation

  • Develop and implement practice policies and procedures around approaching ethical dilemmas involving clients' needs, desire for and access to clinical services


Course Description

Since the introduction of managed mental health care, some social workers feel compelled and somewhat justified to engage in “creative” diagnosing, documenting, billing and coding practices.  Here and there they tweak a CPT code to obtain reimbursement for sessions, minimize or exaggerate symptoms to fit the client into the more desired diagnosis code, omit key clinical information in the case record to protect a client's reputation or privacy and/or randomly adjust fees in order to work with certain clients.

 
In this workshop, the presenter will explore these common and often overlooked unethical and illegal practices, using the NASW Code of Ethics as the primary guide and with specific reference to the important social work values of Service, Integrity and Social Justice.  


Target Audience
This workshop is designed for the intermediate level private practitioner who wants to avoid committing fraud and to gain a better understanding of the most accurate and ethical ways to diagnose, code, document and bill.

Agenda
Program will be 5 hours of actual time
There will be 2 15 minute breaks mid-morning and mid-afternoon

Lunch will be 60 minutes on your own

 

Fee

$125.00


Program
Introduction (25 minutes)
Discussion of agenda
Goals for the workshop
Overview of key values and standards in the NASW Code of Ethics

Documentation of financial matters (25 minutes)
Compliance with COE, NJ state regulations and federal laws
What and how to document fees charged and paid

Informed consent and fees (25 minutes)
How to meet informed consent standards
Review of the NASW COE guidelines and state and federal mandates
The rationale for written policies, procedures and agreements
Required legal notices all social work private practitioners need to be aware of

Break- 15 minutes

Fee setting (60 minutes)
Fairness and fees- legal and ethical considerations

LUNCH ON OWN – 1 hour

Fraud and deception (70 minutes)
Definitions- DHHS, NASW COE and regulatory laws
Examples of misrepresentation
Accurate representation of services provided- The COE, regulatory and federal laws
Theft by deception: upcoding, downcoding and miscoding
Accuracy in DSM diagnoses, CPT coding, billing, clinical and financial record-keeping
Common pitfalls around billing: couples, late arrivals, no shows, longer sessions, and phone and tele-therapy

BREAK- 15 minutes

Fraud and Deception continued --Deductibles, co-insurance and copays (70 minutes)
Common mistakes clinicians make regarding reducing fees
Review of federal laws and ethics guidelines around documentation, collection efforts, fee waivers
Factors to consider when developing a sliding scale
How to incorporate a sliding scale and/or pro bono work in your private practice
Determining and documenting client’s financial need

Review of steps to minimize fraudulent billing, coding, documenting and diagnosing (25 minutes)
How to comply with the NASW-COE and relevant laws
Practical guidelines to develop policies and procedures
Insuring accuracy in documentation and record-keeping
Critical involvement of education, consultation and supervision
   

 

Deadlines, Cancellation/Refund Policies, Complaints, ADA Needs, Questions/Concerns

  • If participants have any questions or concerns or are dissatisfied with any part of the registration process, facilities, non-receipt of certificates,  the presenter or the presentation, or any other complaints, they should contact Leslie S. Tsukroff, MSW, LCSW, the program administrator directly @ 973-879-1678 or @ LsTsukroff@aol.com

  • In order to assist in the ethical and timely resolution of grievances, Leslie S. Tsukroff, Inc.’s Auxiliary Social Work Consultant, Laura Taylor, MSW, LSW will be actively involved in addressing and resolving all disputes.   

  • If the results of the grievance process are unsatisfactory, New Jersey social workers have the option to contact the approving entity, with an option to appeal to their licensing board.

  • All complaints will be responded to within 7 days from the receipt of the complaint.

  • Full refunds will be given to registrants up until 1 week (7 days) prior to the event.  

  • Requests for refunds must be made in writing and mailed to Leslie S. Tsukroff, Inc., Business Management Consulting for Mental Health Practitioners, 68 North Bridge Street, Somerville, NJ 08876 or via e-mail to LsTsukroff@aol.com.

  • Mail and E-mail registration deadline is 3 days prior to the event (Event date TBD).

  • Leslie S. Tsukroff, Inc. would be happy to accommodate your ADA Needs.  Please call (973-879-1678) to discuss at least 2 weeks prior to event.

  • If you have any questions, please call Leslie S. Tsukroff, MSW, LCSW @ 973-879-1678 or email at LsTsukroff@aol.com


Course Completion

In person

  1. For those who registered on-line, by phone or via mail, certificates will be handed to social workers who attend the entire session and complete a course evaluation.

  2. For those who register on-site, certificates will be emailed/mailed within 7 days to those social workers who attend the entire session and complete a course evaluation.

Live, interactive webinar: 
Certificates will be e-mailed to participants within 7 days:

  1. Who attend the entire session

  2. Return a completed course evaluation.  

  3. Course evaluations will be e-mailed to registrants who attend the entire session, within 30 minutes of the workshop ending. 

  4. Course evaluations may be e-mailed to LsTsukroff@aol.com or mailed to the offices of Leslie S. Tsukroff, Inc., 68 North Bridge Street, Somerville, NJ 08876

How to Register

  • On-line: Click "Course Dates/Location & Registration" button below to register and pay on-line with a credit card or print registration form and mail

  • By Phone: 973-879-1678 to register and pay with a credit card or to request a registration form

  • E-mail: LsTsukroff@aol.com to request a registration form


Presenter
Leslie S. Tsukroff, MSW, LCSW
began her entrepreneurial career in 1999 when she opened her first private practice location in Somerset County, New Jersey. Since earning her MSW in Clinical Social Work in 1993 from New York University, she gained expert knowledge through an extensive career.

In addition to owning a profitable and successful private practice, in 2000, Ms. Tsukroff launched
Business Management Consulting for Mental Health Practitioners, a corporation aimed at mentoring behavioral health clinicians as they navigate the process of developing and nurturing a successful, lucrative and rewarding private practice. 

Ms. Tsukroff is the
Founder and Executive Director of Leslie S. Tsukroff, Inc. She perfected her consulting business out of knowledge she gained through creating and managing her own small business, working as an Outpatient Care Manager for one of New Jersey’s largest Managed Care Companies, and from spearheading start-up programs for former employers.

Ms. Tsukroff’s commitment to core social work values is evidenced by her volunteerism to various professional mental health associations. She is honored to have served on a 6-person, national task force charged with expanding and revising NASW’S Clinical Social Workers in Private Practice:  A Reference Guide (Clinical Social Workers in Private Practice: A Reference Manual – anticipated release date spring 2022).  In addition to providing input on the entire document, Ms. Tsukroff lent her professional ethics and private practice expertise by authoring sections on the subjects of professional wills, retirement and closing a private practice, minor's rights, issues impacting minors whose parents are divorced/separated, business planning, subpoenas, sliding scales, client–social worker practice agreements, informed consent standards and suggested case record forms.

Ms. Tsukroff has dedicated over 25 years to giving back to the social work community through serving on various Boards of Directors, writing articles, offering pro-bono workshops, and providing low-cost supervision and consultation to social workers throughout the tristate area.  In June 2020, Ms. Tsukroff returned to the Board of Directors of the New Jersey Association of Women Therapists, serving as the organization’s 21st President.   She is the former Chair for The New Jersey Chapter of The National Association of Social Workers Committee on Ethical Review and throughout her career she has served on several additional committees focused on continuing education for social workers, private practitioner concerns, insurance and managed care issues and social work licensure rules and requirements.

Ms. Tsukroff has a passion for the collaborative learning process, providing professional continuing education and drawing on her clinical/ethics–related experience and expertise.
She conducts engaging training workshops focusing on traditional business practices, risk management techniques, documentation and record-keeping, private practice development, billing, ethical and legal issues and clinical matters.