Optum denials

Messages
1
Location
St. Petersburg, FL
Best answers
0
We constantly get medical records requests from Optum and they take 4-5 months to review and make a determination. It's making our UHC AR a complete disaster. They also just recently they sent us a list of over 100 claims for post-service review. Some of those claims were as far back as 2018. They decided to overturn quite a few of the payments and I have been appealing those for months... they just keep sending them back saying their decision was upheld, but with no real explanation. Nothing we can do about it because they will just offset future payments whether their post-service denials are valid or not. We've contemplated not even taking UHC anymore because it's such a nightmare with the Optum record requests.
 

suki_26

Networker
Messages
42
Best answers
0
I agree with the above. Its getting really bad. My coworker got ahold of a an email to someone in the UHC Corporate office. . She did some serious digging for that. Sent multiple letters and it actually got better for a while..they are slowly asking for more medical records again and its mainly the same few patients
 
Messages
2
Best answers
0
They are asking for the records yes but, the simple thing I found is whenever they ask for records I use their portal and submit records in minute and right after 7 days we get their response either its denied or approved or whatever the status is.
 
Top