Are You Ready for An Audit?
Diagnosing, Documenting, Billing and Coding in Private Practice
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
Develop and implement practice policies and procedures around approaching ethical dilemmas involving clients' needs, desire for and access to clinical services
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.
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.
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
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
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 developed Business Management Consulting for Mental Health Practitioners, a corporation aimed at assisting behavioral health clinicians achieve their business goals.
Ms. Tsukroff 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 the former Chairperson 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 dedicated over 26 years focused on giving back to the social work community through serving on various Boards of Directors, writing articles, offering pro-bono presentations, and providing low-cost supervision and consultation to social workers throughout the tristate area.
In February of 2018, Ms. Tsukroff accepted an invitation to join a task force charged with revising NASW’s Clinical Social Workers in Private Practice: A Reference Guide.
Ms. Tsukroff has a passion for teaching 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.
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, the program administrator directly @ 973-879-1678 or @ LsTsukroff@aol.com.
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 e-mail her @
Continuing Education Credit Information
Are You Ready for An Audit? Diagnosing, Documenting, Billing and Coding in Private Practice, Course #2207, is approved by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program to be offered by Leslie S. Tsukroff, Inc. 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 01/17/2019 to 01/17/2021. Social workers completing this course receive 5 Ethics continuing education credits.
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.
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.