Wiki ONet??

[chirodana]

Good evening everyone. We're starting to see reviews and denials by 'ONet' for Aetna and have heard rumblings that they will start doing some for UHC. Problem here is...they aren't following the medical policy or normal billing rules.

HELP?!?!?!?!?!?!?!

 

[SharonCollachi]

Who is "ONet" and do you have a contract with them? The only thing I could find under that name is a place to find job categories/job descriptions.

 

[Melissa Harris CPC]

I have some issues with Orthonet. They review procedures for coding and policy. I receive denials like "procedure not documented" or "Not medically necessary". 80% of the time I have to appeal because they are incorrect, and even have had to have peer reviews with my physicians. If you know you are correct, appeal with them and not the insurance company. Hope this helps!

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management

 

[SharonCollachi]

In light of this information, I would review my contracts with the insurance companies and you may be able to refuse to accept their involvement.