Accurate Diagnosis, Documentation, Billing and Coding in Private Practice
Formerly, Are You Ready for An Audit?
Diagnosing, Documenting, Billing and Coding in Private Practice
5 Ethics CEs
Perpetrating Fraud? Accurate Diagnosis, Documentation, Billing and Coding in Private Practice, Course #4858, 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. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE course approval period: 03/16/2023 - 03/16/2025. Social workers completing this course receive 5 ethics continuing education credits.
ACE individual course approval meets the NJ Board of Social Work Examiners requirements for individual course approval pursuant to NJ Code 13:44G-6.4.16.
Approved Delivery Methods and Formats:
Distance learning: Live, interactive and synchronous distance
Join New Jersey’s premier ethics consultant, Leslie S. Tsukroff, MSW, LCSW for an informative and interactive workshop in which participants will leave being able to:
1. Identify fraudulent practices around billing, coding, diagnosing and documentation
2. Outline key steps to ensure accurate and compliant billing, coding, diagnosing and documentation practices
3. Develop and implement practice policies that ethically and legally support and facilitate clients’ access to mental health services
Clinicians who fail to fully understand the laws, requirements and best practice standards around setting fees, documenting and billing for services, applying standardized place of service, modifier and CPT codes, and formulating accurate diagnoses leave themselves and their practice open to serious risk.
Whether practitioners knowingly and deliberately violate the law in order to circumvent reimbursement requirements or act on misinformation obtained from well-meaning, but ill-informed colleagues, supervisors or Facebook, fraudulent practices can leave practitioners vulnerable to insurance company clawbacks, allegations of unethical conduct and licensing board complaints.
Centered around the core value of Integrity, the presenter will address the ethical, legal and financial implications of: improperly recording the services provided and fees charged and paid in the medical record; unfair and inequitable fee setting; and engaging in common fraudulent billing and collection practices.
This workshop is designed for the intermediate level private practitioner who wants to avoid perpetrating fraud and to gain a better understanding of the most accurate and ethical ways to diagnose, code, document and bill.
Course Content Level
Program will be 5 hours of actual time
There will be two, 10 minute breaks mid-morning and mid-afternoon
Lunch will be 30 minutes on your own
Introduction (20 minutes)
Discussion of agenda
Goals for the workshop
Overview of key values and standards in the various Codes of Ethics -integrity, fraud, dishonesty and deception
Documentation of financial matters (30 minutes)
Compliance with COE, NJ state regulations and federal laws
What and how to document fees charged and paid
Accuracy in coding
Discussion of Case examples
Informed consent, fees and financial arrangements (35 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/consents
What should be included in the financial policy
Required legal notices all private practitioners need to be aware of
Large group discussion- case example
Break- 10 minutes
Fees (40 minutes)
Fairness, prohibitions and fee setting - legal and ethical considerations
Large group discussion- case examples
Fraud and deception (40 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
Large group discussion- case examples
Lunch on own 30 minutes
Fraud and Deception continued (55 minutes)
Accuracy in DSM diagnoses, CPT coding, billing, clinical and financial record-keeping
Common pitfalls around billing: service provider, couples, late arrivals, no shows, longer sessions, and phone and tele-therapy
Common mistakes regarding establishing and collecting fees (50 Minutes)
Deductibles, co-insurance and copays
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 (20 minutes)
How to comply with the COE and relevant laws
Practical guidelines to develop policies and procedures
Ensuring accuracy in documentation and record-keeping
Critical involvement of education, consultation and supervision
Q and A/final thoughts (10 min)
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 @ LTsukroffLCSW@Hushmail.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 LTsukroffLCSW@Hushmail.com
Registration Deadlines: BY MAIL 7 days prior to event. BY E-MAIL 1 day prior to the event. ONLINE- 90 minutes prior to event.
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 @ LTsukroffLCSW@Hushmail.com
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.
How to Register
Register and pay on-line with a credit card
By Phone: 973-879-1678
Register and pay with a credit card or
Request a registration form
Request a registration form
Leslie S. Tsukroff, MSW, LCSW is the Founder and Executive Director of Leslie S. Tsukroff, Inc, which encompasses both her private psychotherapy practice and her consulting business, Business Management Consulting for Mental Health Practitioners. Leslie hails from a long line of entrepreneurs, following in the footsteps of her grandfathers, uncles, father and her mother. Prior to launching her own psychotherapy practice in 1999, she worked in the trenches as a child/family preventative services worker, an on-site school mental health counselor, and as staff clinician at a community-based agency. She gained further invaluable knowledge while developing clinical preventive programs for at-risk youth, spearheading startup programs for non-profits and working as an outpatient care manager during the rise of managed care during the 1990s.
Leslie is a recognized authority in professional ethics, risk management and private practice development in New Jersey. Her passion for social work professional ethics grew from her interest in the law and her prior employment at a law firm during college. While she determined early on that a career in law was not the right fit for her, serving on the NASW-NJ Ethics Committee and later being appointed Chairperson presented the opportunity to meld her clinical, ethical and legal worlds.
Most recently, she had the honor and privilege of serving on a task force charged with developing a new, comprehensive, and practical document for NASW entitled, “Clinical Social Workers in Private Practice: A Reference Manual.” In addition to providing input on the entire document, Leslie 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.
With close to 3 decades of giving back to the social work and mental health communities, Leslie has served on various Boards of Directors, written articles, offered pro-bono presentations, and provided low-cost supervision and consultation to mental health professionals throughout the tri-state area. As a Qualified Clinical Supervisor in New Jersey, she is committed to ensuring future generations of clinical social workers have the necessary skills to practice competently and ethically. Throughout her career she has served on several professional committees/task forces focused on continuing education for social workers, private practitioner concerns, insurance and managed care issues and social work licensure rules and requirements.
Leslie conducts engaging training workshops focusing on traditional business practices, risk management, documentation and record-keeping, private practice development, billing, ethical and legal issues and clinical matters. She has a passion for the collaborative learning process, and drawing on her clinical/ethics–related expertise she provides customized clinical, ethical, and private practice building consultations.
In addition to her mental health consulting business, she maintains an office in Somerville, New Jersey and provides remote psychotherapy to clients located in New Jersey and Pennsylvania.