Optum Seeks To Recoup Overpayments To Out-Of-Network LCSWs

Optum Behavioral Health is notifying licensed clinical social workers (LCSWs) who served Optum Medicare Advantage members on an out-of-network basis between January 1, 2022, and February 28, 2024, that Optum mistakenly reimbursed them at the wrong rate. Optum Recovery Services is seeking recovery of the overpayments, which range from hundreds to thousands of dollars. Optum has not announced the aggregate value of the overpayments. The affected provider organizations will have 12 months to repay.

The overpayments occurred due to an error within Optum’s claims payment system. The LCSWs had been reimbursed at 100% of the Medicare fee . . .