Wiki UHC Requesting at a rapid, pace, denying Initial Consultations, as documentation does not support, coding -Do Not support Comprehensive History

[kguzikowski]

Is anyone else experiencing this with UHC, constant request for Medical records related to claim submission. Records are sent on the portal to UHC . UHC /OPTUM Reviews receive letter back, denying, looking additional documentation.
Many times Initial Consultation is denied, not supported. This is the only payer that is constantly requesting records, and denying services. Thoughts, Suggestion????

 

[amyjph]

Are you sure you aren't on pre-payment review?

 

[kguzikowski]

I'm not aware of us being on a Pre-Payment Plan review, How would I even know if our practice is set up with UHC on a pre-payment plan review ?