Episode 622: Must You Complete the Note Before Submitting the Claim? Fraud, Mistakes, and the Rules That Actually Apply

Welcome solo and group practice owners! We are Liath Dalton and Evan Dumas, your co-hosts of Group Practice Tech.

In our latest episode, we debunk myths around documentation and fraud with Dr. Maelisa McCaffrey.

We discuss:

• A recent article that is causing concern about whether submitting insurance claims before notes are complete constitutes fraud
• Fraud vs. mistakes, and consequences for mistakes in billing
• What constitutes fraud under the False Claims Act, with context from Eric Ström, HIPAA and mental health law attorney and practicing clinician
• Whether there are rules about when notes are supposed to be completed
• Maelisa’s research on whether “late” notes can impact audits or a fraud case
• Claims vs. superbills and what provider obligations are with superbills
• PCT’s training with Maelisa on How Auditors Think
• Changing or amending notes, and what that looks like in practice 
• Doing notes on paper if you struggle with overthinking your notes
• Just doing the documentation, and how you can always amend them later if needed
• Why private practice isn’t for everyone, and that’s okay
• How effective policies and procedures around documentation (and more) can help with hiring and retention for group practices

Listen here: https://personcenteredtech.com/group/podcast/

For more, visit our website.

PCT Resources:

• PCT CE Course (on-demand) Dealing with Insurance: How Auditors Think and Why
  • 3 CE credit hour training (including 1 legal-ethical CE hour) taught by Dr. Maelisa McCaffrey (QA Prep). This updated-and-expanded 2026 training demystifies medical necessity, clarifies what auditors and payers are actually looking for (and why), and helps clinicians document with more confidence and less stress. Includes real examples, sample note review, and practical tools you can use immediately — covering informed consent language for clients using insurance, treatment planning that supports insurance requirements without sacrificing clinical judgment, and self-auditing techniques to spot red flags before anyone else does. Includes handouts/resources such as diagnosis justification statements, common treatment goals, progress statement formulas and examples, sample progress notes, and a client file review tool.
• Special Office Hours & Group Practice Office Hours direct support and consultation session with guest expert and co-facilitator Dr. McCaffrey: August 6th, 2026. Accessible to Practice Care Premium members/subscribers.