Retrospective chart reviews under managed care: Will payment be authorized?

The article discusses issues concerning the medical reviews required by managed care organizations (MCOs) and insurance companies and whether they can be done after rather than during treatment. If reviews are not read until after treatment, MCOs and insurance companies are not aware of the services until they receive the claim. If reviews are done retrospectively, the MCOs could audit the charts and the documentation, find discrepancies, and possibly rescind authorization.