Has anyone have experience with UHC denials after a review of charges is done by MedReview. UHC sends the results of the outlier audit. They typically want the hospital to supply orders and documentation of charges/services/supplies. I supply them with a detailed line item report with orders and documentation to support charges/services/supplies. When they respond the appear to randomly reverse the denial on a portion of the items. They state no documentation/order supplied when it was. anyone having this experience? Do you resubmit the documents on the items that were not reserved? Do you have success a second time around? Any information on how to handle theses appeals would be greatly appreciated.
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