One should always be concerned about any audit coming from the payer, but not to the point that you say, I will never perform this service again. Take a look at the chart note to determine whether or not the chart note met Optum's policy provisions.
If not, what were the deficiencies and fix the "template" you may be utilizing.
A one chart review resulting in a negative finding, may trigger another probe of more charts or may result in a simple slap on the wrist with the result of do much better next time.
On the other hand if the code being reviewed is sujbect to signficiant fraud and abuse, then the one code one chart auit may result in a much larger scaled audit.
I received a request from Optum representing UHC to send in my medical records for a minor procedure. Should I be concerned about a “Pre-Payment” review? Is there any advice on what to do?
One should always be concerned about any audit coming from the payer, but not to the point that you say, I will never perform this service again. Take a look at the chart note to determine whether or not the chart note met Optum's policy provisions.
If not, what were the deficiencies and fix the "template" you may be utilizing.
A one chart review resulting in a negative finding, may trigger another probe of more charts or may result in a simple slap on the wrist with the result of do much better next time.
On the other hand if the code being reviewed is sujbect to signficiant fraud and abuse, then the one code one chart auit may result in a much larger scaled audit.
I received a request from Optum representing UHC to send in my medical records for a minor procedure. Should I be concerned about a “Pre-Payment” review? Is there any advice on what to do?