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