Webinar: The Documentation of Medical Necessity: Why It Matters

How many times have you heard an insurance company care advocate deny treatment authorization requests due to, "...lack of medical necessity"? How well do you and your teams truly understanding the illusive term 'medical necessity', and are you sure that your facility is meetings the medical necessity standards of care? Too many behavioral health providers learn the profound significance of poorly documented medical necessity the hard way, either because of struggling to stay open due to poor insurance authorizations, or, worse yet, investigations by either managed care companies or legal authorities. Medical necessity and clinical documentation drive the revenue cycle, yet subpar clinical documentation continues to present a huge challenge for most providers, often resulting in significant financial losses.

This fast-paced Continuing Education webinar features Utilization Review expert Elizabeth Irias, LMFT, the President and Founder of Clearly Clinical, and specialized behavioral health attorney Nicholas Merkin, Esq., the CEO of Compliagent. Beth and Nick will discuss what's at stake when your company's documentation of medical necessity is inadequate, and will review strategies about the efficient integration of Medical Necessity into clinical documentation. This dynamic webinar is a great and efficient opportunity for you to learn critical information to help you stay on track legally and improve your Utilization Review outcomes.

Attendees can expect to gain insight into how the appropriate documentation of medical necessity directly reduces liability risk and improves insurance reimbursement, from the frontline initial authorization requests to the bitter end in appeals via medical record reviews. Best practice strategies for protecting the long-term health of your business, pertaining to both clinical and legal best practice, will be discussed alongside the presenters' firsthand experience of the practical application of these concepts.

Learning Objectives:

Upon completing this webinar, participants will be able to:

  • Provide a general definition of the term 'Medical Necessity' as related to Clinical Documentation
  • List two or more consequences of poor documentation of medical necessity
  • Describe at least one conceptualization strategy to improve the documentation of medical necessity

Target Audience: Clinical Managers/Directors, Marriage & Family Therapists, Professional Counselors, Social Workers, Psychologists, Mental Health Counselors, Private Practitioners, Alcohol/Drug Educators, Chemical Dependency Counselors, Rehabilitation Counselors, Alcoholism and Drug Abuse Counselors, Family Physicians, Nurse Practitioners, Physician's Assistants, Admissions Professionals, Utilization Review Professionals, Physicians, Nurses

Learning Level: Intermediate / Advanced

Number of CE Credit Hours: 1 Law & Ethics CE Credit Hour

The Continuing Education credits for this event are being provided by Clearly Clinical. Clearly Clinical is approved by the American Psychological Association to sponsor continuing education for psychologists. Clearly Clinical maintains responsibility for this program and its content. There is no known commercial support for this program, nor any known conflicts of interest. Courses meet the qualifications for continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences; Clearly Clinical is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for California LMFTs, LCSWs, LEPs, and LPCCs. Clearly Clinical maintains responsibility for this program/course and its content; CAMFTCEPA: #99380. Clearly Clinical is approved by California Consortium of Addiction Programs and Professionals-EI; CCAPP-EI, #5172741119 for CEHs.

logos for Clearly Clinical, APA approved sponsor, CAMFT, and CCAPP

In order to receive a certificate of completion, you must pre-register with BHAP and complete the steps outlined in the email that will go out the morning of the webinar. For additional information about the refund/cancellation policy, grievance/complaint procedure, and accommodations, please contact Elizabeth Irias at [email protected].

Register Online Here


Elizabeth Irias, LMFT

Elizabeth Irias, LMFT

Elizabeth Irias, LMFT, is the founder and president of Clearly Clinical, an affordable podcast-based national behavioral health Continuing Education program approved by the APA, CPA, NBCC, NAADAC, CAMFT, and CCAPP.

She has specializations in Utilization Review, Clinical Documentation, and Quality Assurance, and works closely with clinical teams across the country to reduce documentation-related liability risks and improve their quality of care, documentation practices, and Utilization Review outcomes. An adjunct graduate professor at Pepperdine University, Beth is an engaging professional conference speaker, and she provides dynamic, targeted presentations for conferences, seminars, universities, and mental health providers. She also operates a private practice in Westlake Village, CA, where she provides therapy to adolescent/young adult clients, members of the LGBT population, and those with addictive disorders.

Nick Merkin, JD, MBA, CHC, CHPC

Nick Merkin, JD, MBA, CHC, CHPC

Nick Merkin is the Chief Executive Officer of Compliagent, a national healthcare compliance consulting firm based in Los Angeles. As part of his consulting practice, he frequently serves as a fractional or interim Chief Compliance Officer for addiction treatment providers experiencing rapid growth, payment challenges, or in the process of merger or acquisition.

Nick earned his J.D. from Columbia Law School, where he was named a Harlan Fiske Stone Scholar and served as Managing Editor of the Columbia Journal of Law and Social Problems. Nick was also awarded an M.B.A. from Tel Aviv University's Recanati School of Business and a B.A. from the University of Pennsylvania. A member of the California Bar, Nick is certified in Healthcare Compliance (CHC) and Healthcare Privacy Compliance (CHPC) by the Compliance Certification Board (CCB).


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