Insurance Claims: Empowering Your Clients for Coverage

Tuesday, November 16 2021 12:00 PM - 1:00 PM [CST]

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General Admission with CE/CEU Certificate Partial Approval - $10.00

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Tuesday, November 16 2021 12:00 PM - 1:00 PM [CST]

This program is presented in partnership between The Chicago School of Professional Psychology, The Kennedy Forum of Illinois, and The Austen Riggs Center.

Presented by Joe Feldman, MBA, Eric Plakun, MD., Marie Casciari, JD, and the Honorable Patrick Kennedy.

This program, when attended in its' entirety, offers 1.0 CEs for Psychologists, 1.0 CEUs for Illinois state counselors and Social Workers, and 1.0 BBS California CEUs for LMFTs, LPCCs, and LCSWs. 

Program Description:

Insurance coverage for mental health and substance use treatment has long been a challenge compared to coverage for physical health.  While federal and state laws have been implemented over the last several years to require parity treatment (i.e., mental health same as physical health), it remains far too common that claims are denied and coverage is out-of-reach for individuals requiring such care.  More recently, federal lawsuits have been won in favor of patients where insurers improperly, that is illegally, denied claims.  Step-by-step, the landscape may be shifting so that patients will be less likely to confront denied claims.  But we’re not there yet.

Insurers have denied claims for “lack of medical necessity” where that determination has been made independently of the patient’s treating clinician.  Such denials may be confounding to both patients and to their clinicians.  After all, who should be making the determination about whether care is indeed “medically necessary.”

Authors of a recently published article will describe their recommendation for clinicians to provide a “letter of medical necessity” to their patients as a tool to improve the likelihood that insurers timely approve claims.  Such letters have proven crucial in lawsuits and appeals; they represent an important tool that clinicians can provide their patients. 

Learning Objectives:

After attending this workship participants will be able to: 

1. Identify the key principals of the insurance parity laws regarding mental health and substance use treatment. 

2. Describe the landmark Wit decision's reinforcement of expectations for insurers' compliance with parity.

3. Author medical necessity letters to help their patients with insurance coverage for mental health and addiction related treatment.

Program Standards and Goals:

This program meets APA’s continuing education Standard 1.2:  Program content focuses on ethical, legal, statutory or regulatory policies, guidelines, and standards that influence psychological practice, education, or research.

This program meets APA’s continuing education Goal 2: Program will enable psychologists to keep pace with the most current scientific evidence regarding assessment, prevention, intervention, and/or education, as well as important relevant legal, statutory, leadership, or regulatory issues.

 

Registration and Fees:

This program is free to attend. 

CE/CEU Certifcate: $10.00*

*CE/CEU Certificate available without charge for TCSPP Facutly/Staff/Students. 

Refund Policy:

100% of tuition is refundable up to 48 hours before the program. 

References:

Appelbaum, P. S., & Parks, J. (2020). Holding insurers accountable for parity in coverage of Mental Health Treatment. Psychiatric Services, 71(2), 202–204. https://doi.org/10.1176/appi.ps.201900513

Feldman, J. (2019, September 11). 10 Steps to securing insurance coverage for mental health care. Retrieved from https://www.thekennedyforum.org/blog/10-steps-to-securing-insurance-coverage-for-mental-health-care/.

Feldman, J., DeBofsky, M., Plakun, E. M., & Potts, C. (2021). Providing a routine medical necessity letter to improve access to care for our patients. Journal of Psychiatric Practice, 27(4), 288–295. https://doi.org/10.1097/pra.0000000000000563

 

Davenport, S., Gray, T. J., & Meek, S. P. (2019). Addiction and mental health vs. physical health: widening disparities in network use and provider reimbursement. Milliman Report Commission by the Mental Health Treatment and Research Institute

 CONTINUING EDUCATION:

Target Audience: Healthcare and Mental healthcare professionals, Students welcome

Psychologists. This program, when attended in its entirety, is available for 1.0 continuing education credits. The Chicago School of Professional Psychology is committed to accessibility and non-discrimination in its continuing education activities. The Chicago School of Professional Psychology is also committed to conducting all activities in conformity with the American Psychological Association’s Ethical Principles for Psychologists. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If program content becomes stressful, participants are encouraged to process these feelings during discussion periods. If participants have special needs, we will attempt to accommodate them. Please address questions, concerns and any complaints to Danielle Bohrer at 312-467-2364. There is no commercial support for this program nor are there any relationships between the CE Sponsor, presenting organization, presenter, program content, research, grants, or other funding that could reasonably be construed as conflicts of interest.

Counselors/Clinical Counselors. This program, when attended in its entirety, is available 1.0 hours of continuing education. The Chicago School of Professional Psychology is licensed by the Illinois Department of Financial and Professional Regulation (IDFPR) to provide continuing education programming for counselors and clinical counselors.License Number: 197.000159

Social Workers. This program, when attended in its entirety, is available for 1.0 hours of continuing education. The Chicago School of Professional Psychology is licensed by the Illinois Department of Financial and Professional Regulation (IDFPR) to provide continuing education programming for social workers. License Number: 159.001036

MFTs, LPCCs, and LCSWs. Course meets the qualifications for 1.0 hours of continuing education credit for MFTs, LPCCs, and/or LCSWs as required by the California Board of Behavioral Sciences. If you are licensed outside of California please check with your local licensing agency to to determine if they will accept these CEUs. The Chicago School of Professional Psychology is approved by the California Board of Behavioral Sciences (BBS) to offer continuing education programming for MFTs, LPCCs, LEPs, and/or LCSWs. The Chicago School of Professional Psychology is an accredited or approved postsecondary institution that meets the requirements set forth in Sections 4980.54(f)(1), 4989.34, 4996.22(d)(1), or 4999.76(d) of the Code.

Participation Certificate. The Chicago School of Professional Psychology is able to provide students and other participants who simply wish to have documentation of their attendance at the program a participation certificate.

Non Psychologists. Most licensing boards accept Continuing Education Credits sponsored by the American Psychological Association but non-psychologists are recommended to consult with their specific state-licensing board to ensure that APA-sponsored CE is acceptable.*Participants must attend 100% of the program in order to obtain a Certificate of Attendance. The Chicago School of Professional Psychology is approved by the American Psychological Association to sponsor continuing education for psychologists. The Chicago School of Professional Psychology maintains responsibility for this program and its content.

*Participants must attend 100% of the program in order to obtain a Certificate of Attendance.

The Chicago School of Professional Psychology is approved by the American Psychological Association to sponsor continuing education for psychologists. The Chicago School of Professional Psychology maintains responsibility for this program and its content.

Office of Continuing Education

Presented in partnership with The Chicago School of Professional Psychology and the Kennedy Forum

Contact the Organizer View other events

Joe Feldman, MBA
Board Member, Kennedy Forum Illinois

Joe Feldman is a Board Member and Co-chair of the Policy Committee of The Kennedy Forum Illinois. Feldman has advocated for mental health care access through legislative outreach in Washington DC, Springfield, and Chicago and was lead author of “Providing a Routine Medical Necessity Letter to Improve Access to Care for our Patients;” Journal of Psychiatric Practice (July 2021) with Mark DeBofsky, Dr. Eric Plakun, Cheryl Potts. Feldman posted “Ten Steps to Securing Coverage for Mental Health Care;” as a blog on the Kennedy Forum website in September 2019 and has been a podcast guest discussing mental health insurance by Atlanta-based Parent’s Journey and Utah-based Evoke Therapy. Feldman is Executive Vice President of North American for Electrochaea, a Munich-Germany alternative energy company. His earlier professional roles have included business development consultant, executive and entrepreneur with fifteen-year record of board experience (corporate, non-profit); leadership roles in four venture-stage technology organizations; fifteen-year record of consulting for middle market companies, development stage businesses and start-ups; nearly twenty-years’ large corporate experience. Previous not-for-profit roles have included board member for Chicago Lights, president and board member for Warming House Youth Center, and chairman of the Wilmette (Illinois) Youth Commission.

About Joe Feldman, MBA

Board Member, Kennedy Forum Illinois
Honorable Partick Kennedy
Former Congressman (RI-D)

About Honorable Partick Kennedy

Former Congressman (RI-D)
Eric Plakun, MD
Medical Director and CEO Austen Riggs Center

Eric M. Plakun, MD, is the medical director/CEO of the Austen Riggs Center, where he is a member of the Senior Leadership Group and the Erikson Institute Management Group. A board certified psychiatrist, psychoanalyst, researcher, and forensic psychiatrist. Dr. Plakun is the editor of New Perspectives on Narcissism (American Psychiatric Press, 1990) and Treatment Resistance and Patient Authority: The Austen Riggs Reader (Norton Professional Books, 2011), and author of close to fifty articles and book chapters on the diagnosis, treatment, longitudinal course and outcome of patients with borderline personality disorder and treatment resistant disorders. He is a Distinguished Life Fellow of the American Psychiatric Association and serves on the APA Board of Trustees representing New England and Eastern Canada. He is a former member of the APA Assembly, where he served as chair of the Assembly Committee of Representatives of Subspecialties and Sections and on the Assembly Executive Committee. In the APA he has also been past chair of the Committee on Psychotherapy by Psychiatrists, and the founding leader of the APA Psychotherapy Caucus. Dr. Plakun is a Fellow of the American College of Psychiatrists, and a Fellow of the American College of Psychoanalysts. He is a Psychoanalytic Fellow and former Trustee of the American Academy of Psychodynamic Psychiatry and Psychoanalysis. Dr. Plakun also served for more than a decade with the American Board of Psychiatry and Neurology as a member of the written test committee and as an oral examiner. In 2003 Dr. Plakun was selected by the 1700-member Massachusetts Psychiatric Society as the “Outstanding Psychiatrist in Clinical Psychiatry.” Dr. Plakun graduated from Hofstra University and received an MD from the Columbia College of Physicians & Surgeons. After an internship in medicine at Dartmouth, Dr. Plakun worked as a rural general practitioner in Vermont before completing a psychiatry residency at Dartmouth and a Fellowship in Psychoanalytic Studies at Riggs.

About Eric Plakun, MD

Medical Director and CEO Austen Riggs Center
Marie Casciari, JD
Partner, DeBofsky, Sherman, Casciari, Reynolds P.C.

Marie Casciari is a shareholder at DeBofsky Sherman Casciari Reynolds P.C., and practices exclusively in the areas of employee benefits, ERISA, mental health parity, and other insurance benefits litigation. Marie Casciari handles litigation at the state court, federal district court, and federal appellate court levels; and manages internal appeals and benefit claim submissions under group and individual benefit plans. Marie Casciari has argued before the United States Court of Appeals for the Seventh Circuit, the United States District Court for the Northern District of Illinois, and the Illinois Circuit Court. She is a graduate of the Loyola University Chicago School of Law and earned a Bachelor of Arts (Philosophy) from Boston University, College of Arts and Sciences in Boston, Massachusetts. Casciari’s published works include: Advancing the Future of Proton Therapy, National Association for Proton Therapy (April 2021); Recent Trends in Transgender Healthcare Law, American Bar Association (June 2020); Federal Court Finds ERISA Does Not Preempt State Auto-Enrollment Individual Retirement Program, Illinois Bar Association (May 2020); Federal Court Finds Insurance Giant Breach Its Fiduciary Duties and Violated Illinois Law, Illinois Bar Association (July 2019); and Chapter Editor, Bloomberg BNA American Bar Association Section of Labor & Employment Law Employee Benefits Law Treatise, 2016-Present

About Marie Casciari, JD

Partner, DeBofsky, Sherman, Casciari, Reynolds P.C.

About The Chicago School of Professional Psychology- Chicago Campus

https://www.thechicagoschool.edu/ Sponsor Logo

About THE AUSTEN RIGGS CENTER

https://www.austenriggs.org/ Sponsor Logo

About The Kennedy Forum of Illinois

https://thekennedyforumillinois.org/ Sponsor Logo