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News Article | March 1, 2017

Financial Recovery Group, Inc. (FRG), is proud to announce it will participate as a Silver Sponsor at the upcoming RISE Nashville Summit in Nashville, Tenn. The company also is offering a special discount for those who attend the event as a guest of FRG. The summit, now in its 11th year, brings together the brightest minds in the healthcare industry to share information on risk adjustment, quality management, financial compliance, care management, performance analytics and engagement strategies. The event includes panel discussions on these topics, as well as presentations from industry leaders on the latest tools for risk revenue optimization, quality data, compliance and audits. The summit also features a unique networking event: a street party on 5th Avenue outside the hotel that will feature live music, food and games. FRG is sponsoring the event to showcase AccuReports®, its online analytical reporting software. FRG specializes in providing services that make complicated healthcare data easy to evaluate, providing clients information they need to identify trends, understand the drivers, and implement medical cost improvement plans. With offices in Miami and Tampa, FRG has clients that include national Health Maintenance Organizations (HMOs), multi-state Management Services Organizations (MSOs) and successful Accountable Care Organizations (ACOs). Through AccuReports®, FRG provides industry leading medical economics reporting to hundreds of provider groups nationwide. “AccuReports® makes it simple for financial managers to understand if an organization’s care management initiatives have worked to bend the cost curve, and it shows them where to look if they haven’t.” – Duncan Belser, VP for Business Development The event is scheduled for March 6-8 at the Omni Nashville Hotel. Those who wish to attend the event as a guest of FRG can receive a 15 percent discount by using the promo code HSM334 when registering for the event. About Financial Recovery Group, Inc Since 1999, Financial Recovery Group (FRG) has helped health plans and physician groups create transparency and improve financial performance through online analytical reports and claims audit – recovery services. Trusted by several national HMOs and over 700 Independent Practice Associations (IPAs), Medical Service Organizations (MSOs) and Accountable Care Organizations (ACOs), FRG brings industry leading medical economics capabilities to your healthcare enterprise. Our proprietary algorithms and rigorous processes make complex health plan data crisp and simple to evaluate. Clients gain the power to build informed medical cost improvement plans and boost Physician Incentive Plan (PIP) bonus payouts. Our expertise and uniquely financial focus make us a healthcare CFO’s best friend.

Literature on test validity and performance validity is reviewed to propose a framework for specification of an ability-focused battery (AFB). Factor analysis supports six domains of ability: first, verbal symbolic; secondly, visuoperceptual and visuospatial judgment and problem solving; thirdly, sensorimotor skills; fourthly, attention/working memory; fifthly, processing speed; finally, learning and memory (which can be divided into verbal and visual subdomains). The AFB should include at least three measures for each of the six domains, selected based on various criteria for validity including sensitivity to presence of disorder, sensitivity to severity of disorder, correlation with important activities of daily living, and containing embedded/derived measures of performance validity. Criterion groups should include moderate and severe traumatic brain injury, and Alzheimer's disease. Validation groups should also include patients with left and right hemisphere stroke, to determine measures sensitive to lateralized cognitive impairment and so that the moderating effects of auditory comprehension impairment and neglect can be analyzed on AFB measures. © 2014 © The Author 2014. Published by Oxford University Press. All rights reserved.

Miller L.,Independent Practice
Aggression and Violent Behavior | Year: 2013

Children are the quintessential innocent victims; therefore, special opprobrium is reserved for offenders who sexually abuse them. This article describes the more prominent typologies of pedophilic sex offenders and discusses the role of child pornography in child sexual abuse of actual children. It next examines the often overlooked population of women offenders who sexually abuse children. Attention then turns to the sexual abuse of children in child care settings and by members of the clergy; practical recommendations are provided for reducing the risk of this kind of institutional child sexual abuse. Theoretical conceptualizations of child sexual abuse are considered, in the three main categories of cognitive-psychodynamic theories, neuropsychological conceptualizations, and contributions from the emerging field of evolutionary psychology. Finally, recommendations are made for developing a way of handling sex offenders, including sexual offenders against children, that balances the fair administration of justice with society's obligation to protect vulnerable potential victims. © 2013 Elsevier Ltd.

Larrabee G.J.,Independent Practice
Journal of the International Neuropsychological Society | Year: 2012

Failure to evaluate the validity of an examinee's neuropsychological test performance can alter prediction of external criteria in research investigations, and in the individual case, result in inaccurate conclusions about the degree of impairment resulting from neurological disease or injury. The terms performance validity referring to validity of test performance (PVT), and symptom validity referring to validity of symptom report (SVT), are suggested to replace less descriptive terms such as effort or response bias. Research is reviewed demonstrating strong diagnostic discrimination for PVTs and SVTs, with a particular emphasis on minimizing false positive errors, facilitated by identifying performance patterns or levels of performance that are atypical for bona fide neurologic disorder. It is further shown that false positive errors decrease, with a corresponding increase in the positive probability of malingering, when multiple independent indicators are required for diagnosis. The rigor of PVT and SVT research design is related to a high degree of reproducibility of results, and large effect sizes of d=1.0 or greater, exceeding effect sizes reported for several psychological and medical diagnostic procedures. © 2012 INS. Published by Cambridge University Press.

Miller L.,Independent Practice
Aggression and Violent Behavior | Year: 2014

While rates of juvenile crime have declined over the past decade, public preoccupation with youth violence remains high, periodically fueling judicial and legislative "get-tough" policies and social movements. For most young people, criminal activity, if any, is mild, infrequent, peer-driven, and peaks in late adolescence and early adulthood, declining steadily thereafter. A small subset of persistently antisocial youths begin their criminal careers earlier, commit more frequent and more serious offenses, continue their offending throughout the life-course, and are characterized by a number of neurocognitive, personality, and diagnostic features. Individual, familial, and social forces all combine to influence juvenile criminal behavior, but another small subset of youths, with a characteristic cognitive and temperamental profile, appear to be staunchly resilient to the criminogenic influences around them. The success of intervention and treatment modalities for childhood antisocial behavior depends both on the type of subjects to which they are applied and the consistency and comprehensiveness with which they are implemented and carried out. © 2014.

Chafetzl M.,Independent Practice | Underhill J.,Independent Practice
Archives of Clinical Neuropsychology | Year: 2013

The feigning of disabling illness for the purpose of disability compensation, or "malingering," is common in Social Security Disability examinations, occurring in 45.8%-59.7% of adult cases. In this study,we estimated the costs of malingering based on mental disorder data published by the Social Security Administration. At the most widely accepted base rate of malingering in medicolegal cases involving external incentive, costswere high, totaling $20.02 billion in 2011 for adult mental disorder claimants. Moreover, these figures clearly underestimate the costs of the larger problem with feigned disability in both adults and children.We urge a change in Social Security policies to allowthe use of validity testing in the examination for disability claims. © The Author 2013. Published by Oxford University Press. All rights reserved.

Chafetz M.,Independent Practice
Clinical Neuropsychologist | Year: 2011

The Symptom Validity Scale (SVS) for low-functioning individuals (Chafetz, Abrahams, & Kohlmaier, 2007) employs embedded indicators within the Social Security Psychological Consultative Examination (PCE) to derive a score validated for malingering against two criterion tests: Test of Memory Malingering (TOMM) and Medical Symptom Validity Test (MSVT). When any symptom validity test is used with Social Security claimants there is a known rate of mislabeling (1-specificity), essentially calling a performance biased (invalid) when it is not, also known as a false-positive error. The great costs of mislabeling an honest claimant necessitated the present study, designed to show how multiple positive findings reduce the potential for mislabeling. This study utilized a known-groups design to address the impact of using multiple embedded indicators within the SVS on the diagnostic probability of malingering. Using four SVS components, Sequence, Ganser, and Coding errors, along with Reliable Digit Span (RDS), the positive predictive power was computed directly or by the chaining of likelihood ratios. The posterior probability of malingering increased from one to two to three failed indicators. With three failed indicators, there were essentially no false positive errors, and the total SVS score was in the range consistent with Definite Malingering, as shown in Chafetz etal. (2007). Thus, in a typical PCE when an examiner might have only a few embedded indicators, more confidence in a diagnosis of malingering might be obtained with a finding of multiple failures. © 2011 Psychology Press.

Binder L.M.,Independent Practice
Clinical Neuropsychologist | Year: 2011

The frequencies of differences between highest and lowest subtest scores as a function of highest subtest score (relative scatter), are reported for the standardization sample of the Wechsler Adult Intelligence Scale-IV (WAIS-IV). Large differences between highest and lowest subtest scores were common. The degree of relative scatter was related to the height of the highest subtest score. For the 10 core WAIS-IV subtests, the correlation between the level of the highest subtest score and the amount of scatter was r =.62; for all 15 subtests the correlation was. 63. The level of the highest subtest score was more strongly related to scatter than was Full Scale IQ. Clinical implications for inferring cognitive impairment and estimating premorbid abilities are discussed. When considering the possibility of acquired cognitive impairment, we recommend caution in the interpretation of subtest score differences. © 2011 Psychology Press.

Miller L.,Independent Practice
Aggression and Violent Behavior | Year: 2012

Stalking is generally defined as an intentional pattern of repeated intrusive and intimidating behaviors toward a specific person that causes the target to feel harassed, threatened, and fearful, or that a reasonable person would regard as being so. Motivations for stalking include a delusional belief in romantic destiny, a desire to reclaim a prior relationship, a sadistic urge to torment the victim, or a psychotic overidentification with the victim and the desire to replace him or her. Stalkers may carry a variety of diagnostic labels, including psychotic disorders, delusional disorders, or cluster-B personality disorders, and are generally refractive to conventional psychological treatments. Risk factors for violence in a stalking scenario include a prior intimate relationship, the stalker's feeling of being rejected or humiliated, and generic risk factors for violence such as low educational level and substance abuse. Cyberstalking can be as distressing, if not more so, to victims as physical stalking due to the concealment and anonymity afforded by electronic communication. Victims may adopt varying strategies for dealing with stalkers, such as avoiding, confronting, seeking third party assistance, and accessing the legal system. Threat management specialists have offered certain recommendations that can make it easier for a victim to deter and discourage a stalker. © 2012 Elsevier Ltd.

Bilder, Sugar, and Hellemann (2014 this issue) contend that empirical support is lacking for use of multiple performance validity tests (PVTs) in evaluation of the individual case, differing from the conclusions of Davis and Millis (2014), and Larrabee (2014), who found no substantial increase in false positive rates using a criterion of failure of ≥ 2 PVTs and/or Symptom Validity Tests (SVTs) out of multiple tests administered. Reconsideration of data presented in Larrabee (2014) supports a criterion of ≥ 2 out of up to 7 PVTs/SVTs, as keeping false positive rates close to and in most cases below 10% in cases with bona fide neurologic, psychiatric, and developmental disorders. Strategies to minimize risk of false positive error are discussed, including (1) adjusting individual PVT cutoffs or criterion for number of PVTs failed, for examinees who have clinical histories placing them at risk for false positive identification (e.g., severe TBI, schizophrenia), (2) using the history of the individual case to rule out conditions known to result in false positive errors, (3) using normal performance in domains mimicked by PVTs to show that sufficient native ability exists for valid performance on the PVT(s) that have been failed, and (4) recognizing that as the number of PVTs/SVTs failed increases, the likelihood of valid clinical presentation decreases, with a corresponding increase in the likelihood of invalid test performance and symptom report. © 2014 Taylor & Francis.

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