APA Questions Oxford About Retrospective Audits
Marcia Goin, M.D., Ph.D., APA president, and James H. Scully Jr., M.D., APA medical director, voiced APA’s concerns about the retrospective medical record audits that were recently conducted by Oxford Health Plans in New York, Connecticut, and New Jersey. On behalf of APA, they wrote to the CEO of Oxford, Charles Berg. The letter, dated November 7, directly challenged the scope and propriety of the reviews.
APA took Oxford to task on four issues:
| •. | Psychiatrists being held accountable to unknown, or nonexistent, documentation standards. | ||||
| •. | The undisclosed qualifications of the medical record reviewers. | ||||
| •. | The lack of ability for psychiatrists to take corrective action. | ||||
| •. | The failure to preserve patient confidentiality. | ||||
The letter asserted that the results of the audit were without proper basis and should not go forward. APA officials have requested a meeting with Berg.
Read a copy of the Oxford letter on the APA Web site at www.psych.org in “Members Corner” under “Newsletters,” where you can also find the most recent issue of Psychiatric Practice & Managed Care.
