‘Assumed guilty until proven innocent’: Exploring the conflict between physicians and insurers regarding ‘downcoding’
Insurance Downcoding Practices Under Scrutiny Aetna’s representative, David Witrup, stated that insurance companies have a responsibility to oversee proper coding on behalf of their clients and members, as well as to combat fraud and mismanagement in the governmental programs they support. He emphasized that reviewing Level 4 and 5 codes is crucial to ensure that […]