Article

2020, Now What? Third Party Payor Audit?

Provided by:  Jennifer Kirschenbaum, Esq.

August 4, 2020 

Question:

Hi Jennifer, 

I have to rant for a minute.  Why is it more than half the country is out of work but UHC is taking the time to send me an audit and recoup money? 

Are other clients commenting on this?  Now what?

Dr. P

Answer:


Yes.  You are not alone.  The third party payors are back to work and back to auditing; business as usual; nothing to see here!  You are also not alone in crying, Foul!  The Department of Financial Services is back at work as well, and fielding complaints if there is questionable behavior of a payor.  Representatives at third party payors are most certainly working and are available to discuss resolution of claims issues, from our experience the past few weeks. 

So, now what?  Without knowing more details on why the practice and/or services have been flagged, here is some general advice...  Do not allow the static of the moment delay response.  Do not risk the carrier offsetting from current claims - which is a disaster to track and disastrous to revenue stream.   Let's streamline a strategy and approach to the carrier and work towards a palatable resolution.  



Looking for the KK Healthcare Exchange?  Click Here. 

MISSED OUR RECENT WEBINARS?  CLICK HERE ANYTIME!
Looking for HIPAA and compliance forms?  
Click here to visit our website.
Have a question or comment for Jennifer?
Contact Jennifer at Jennifer@Kirschenbaumesq.com or  at (516) 747-6700 x. 302.
Interested in having Jennifer speak at an event or
at a residency/fellowship program?
Contact Jennifer directly at (516) 747-6700 x. 302 or at Jennifer@Kirschenbaumesq.com
Click here to learn about
K&K's Prepaid Legal Audit/Investigation Defense Now!
2020, Now What? Third Party Payor Audit?-August 4, 2020-Jennifer Kirschenbaum

Article

2020, Now What? Third Party Payor Audit?

Provided by:  Jennifer Kirschenbaum, Esq.

August 4, 2020 

Question:

Hi Jennifer, 

I have to rant for a minute.  Why is it more than half the country is out of work but UHC is taking the time to send me an audit and recoup money? 

Are other clients commenting on this?  Now what?

Dr. P

Answer:


Yes.  You are not alone.  The third party payors are back to work and back to auditing; business as usual; nothing to see here!  You are also not alone in crying, Foul!  The Department of Financial Services is back at work as well, and fielding complaints if there is questionable behavior of a payor.  Representatives at third party payors are most certainly working and are available to discuss resolution of claims issues, from our experience the past few weeks. 

So, now what?  Without knowing more details on why the practice and/or services have been flagged, here is some general advice...  Do not allow the static of the moment delay response.  Do not risk the carrier offsetting from current claims - which is a disaster to track and disastrous to revenue stream.   Let's streamline a strategy and approach to the carrier and work towards a palatable resolution.  



Looking for the KK Healthcare Exchange?  Click Here. 

MISSED OUR RECENT WEBINARS?  CLICK HERE ANYTIME!
Looking for HIPAA and compliance forms?  
Click here to visit our website.
Have a question or comment for Jennifer?
Contact Jennifer at Jennifer@Kirschenbaumesq.com or  at (516) 747-6700 x. 302.
Interested in having Jennifer speak at an event or
at a residency/fellowship program?
Contact Jennifer directly at (516) 747-6700 x. 302 or at Jennifer@Kirschenbaumesq.com
Click here to learn about
K&K's Prepaid Legal Audit/Investigation Defense Now!