UPIC Denials and the Inevitable Business Decision: Appeal or Pay? A Cautionary Tale
The following is based on a true story. Warning: This is not a bedtime story! Content may induce sleeplessness or even nightmares. The Initial UPIC Audit A busy wound care practice receives a Unified Program Integrity Contractor (UPIC) medical record request covering a small number of patients with multiple dates of service. The practice responds, producing the requested records and supporting documentation. A few months later, the decision arrives: 100% denial. While certainly not the…
