Full access
Association News
Published Online: 19 December 2003

NYSPA, APA Protest Causes Insurer to Halt Record Audits

Christine LehmannAuthors Info & Affiliations
Publication: Psychiatric News
Volume 38, Number 24
https://doi.org/10.1176/pn.38.24.0001a
PDF/EPUB
Oxford Health Plans, a managed care company based in Connecticut, said last month it will stop auditing psychiatrists and mental health professionals for documentation of therapy sessions (Psychiatric News, November 7; also see page 3).
Oxford pledged to refund amounts paid by audited psychiatrists and mental health professionals to settle claims of alleged documentation errors and return copies of patient records, according to Oxford spokesperson Maria Gordon Shydlo.
Oxford’s chief medical officer, Alan Muney, M.D., said in a press release that the company realized that the variability in documentation of therapy sessions by clinicians was not due to fraud but inconsistent documentation guidelines.
APA and the New York State Psychiatric Association (NYSPA) said they were pleased with Oxford’s decision to terminate audits of psychiatrists and mental health professionals.
APA President Marcia Goin, M.D., told Psychiatric News, “Oxford will join with APA, NYSPA, and the New York State Society for Clinical Social Work to develop and adopt mutually acceptable standards for office medical record documentation.”
She continued, “This is a stunning example of what can be achieved through collaboration and informed aggressive efforts on behalf of our members and their patients.”
NYSPA Executive Director Seth Stein, J.D., who hammered out the deal with Oxford, told Psychiatric News, “This is a positive development by Oxford. I was particularly pleased that the company agreed to return copies of patient medical records obtained from audited psychotherapists. I insisted on this to avoid potential breaches of confidentiality that can occur when records are simply disposed of without adequate safeguards.”
Stein plans to meet again with Oxford representatives about the company’s use of the extrapolation method in audits and qualifications of peer reviewers. APA raised concerns about these issues in a November 7 letter to Oxford President and CEO Charles Berg.
The American Psychoanalytic Association and the American Psychological Association wrote Berg in October about similar concerns.
“We also want to ensure that if Oxford uses the documentation standards as a measure of compliance in future mental health care audits, [the company should] disclose the purpose and protocol for audits and any payment recovery plan to psychotherapists before they sign the contract,” said Stein.
APA’s November 7 letter to Oxford is posted on the APA Web site at www.psych.org/news_room/press_releases/CE_letter.cfm. ▪

Information & Authors

Information

Published In

Go to Psychiatric News
Psychiatric News
Volume 38 • Number 24 • December 19, 2003
Pages: 1

History

Published online: 19 December 2003
Published in print: December 19, 2003

Notes

Oxford Health Plans announces that it will stop auditing psychotherapists’ records for documentation of sessions and develop consistent standards with APA and the NYSPA.

Authors

Affiliations

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard
Tips for downloading citations

There are no citations for this item

View Options

View options

PDF/ePub

View PDF/ePub

Get Access

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share

×

As described within the American Psychiatric Association (APA)'s Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences. Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.