Appeals: Use of the Law, Contract Language, and Documentation
Date: October 17, 2019
Time: 6:00 – 7:30 PM Eastern time
Location: Online (GoToWebinar)
Cost: APBA Members: $15.00
The non-refundable fee includes 1.5 Type 2 BACB CEUs for participants who sign up for them, are present for the entire session, and complete a brief quiz.
Access to a recording of the webinar will be made available for purchase sometime after August 28, but CEUs will be available only for those who participate in the live webinar.
Registration deadline: October 11, 2019 - midnight Eastern time
Description: In part 4 of this 5-part series, we will share information on how to obtain the right to appeal on behalf of your clients and why it is in your interest to do so. We will also discuss timing of appeals and why meeting deadlines is critical; the nuts and bolts of the appeals process; and where to find information specific to your client's policy or plan. Tips will be provided on preparing appeals, documentation that you should have in your files to make responding to appeals easier, and what goes into preparing appeals — both facts and legal arguments.
Jodi Bouer, founder of Bouer Law, LLC, has worked as an insurance coverage litigator for top New Jersey law firms and insurers. She is a tireless advocate for the autism, mental health, and special needs communities, working with providers, advocacy and parent associations, legislators, departments of insurance, and families throughout the country. Jodi has represented families and providers in disputes with insurance companies, including issues related to appeals, authorizations, claims, audits, recoupments, and fraud, successfully litigating and settling cases involving state and federal law. She has been recognized as Lawyer of the Year by Autism Speaks.
Kim Mack Rosenberg is a Bouer Law, LLC partner who formerly litigated at one of the top Big Law firms where her practice focused on insurance litigation and products liability. Like Jodi, Kim has represented families and providers in disputes with insurance companies and provided clients with ongoing practice advice. She has headed non-profits focused on children and adults with special needs and frequently speaks on issues related to autism spectrum disorder. She is the author of The Parent’s Autism Sourcebook: A Comprehensive Guide to Screenings, Treatments, Services, and Organizations (2014).
Michele Silcox is founder of ABA Therapy Billing and Insurance Services and MKS Consulting, a Certified Medical Reimbursement Specialist, and co-author of Revenue Cycle Management – ABA Therapy. Michele has worked closely with Bouer Law, LLC to provide in-depth risk assessments for ABA providers to support compliance and profitability in their practice. With scrutiny and regulation of ABA services increasing, providers need to know when they are at risk for non-compliance and how to avoid fraudulent activity. Michele’s goal is to help providers find that peace of mind.
Gina Green, BCBA-D and CEO of the Association of Professional Behavior Analysts, will serve as BACB CE instructor and moderator for the webinar.
Note: This is the fourth webinar in a 5-part series. Subsequent webinars will cover structuring and submission of appeals, and litigation, mediation. and arbitration considerations. Dates and registration information on the other webinars in this series will be posted on www.apbahome.net.