Wiki United healthcare denials

[TAMMY12]

We have been getting denials on Total Knee (01402 AA). After reviewing records United is denying stating: records do not support services billed. Has anyone else received these denials?

 

[ASH527]

United health

I would check there medical policy for this and see what diagnosis they allow. We are having problems with some of our claims and I am finding they go by what is in there policy. GOOD LUCK

 

[glanter]

We're getting some inaccurate reviews through UHC/Optum

Very frustrating. Procedures that are clearly in the operative notes denied, separate procedures bundled inappropriately, procedures denied as "size of defect" not documented although its right in the operative text? We call, they say to appeal again! I've got one that I have appealed 3 times in writing, even drew a picture, and have called 12 times. It's crazy and I can't seem to get any help at all.

G