UnitedHealthcare New Enhancements Facilitate Streamlined Prior Authorization

December 2019 ~

UnitedHealthcare (UHC) has announced changes to its prior authorization and notification tools, designed to streamline overall online prior authorization submission process and improve process times.

The insurer launched the following new resources for certain prior authorization categories:

  • Therapy Evaluations and Re-evaluations for UnitedHealthcare Community Plan members in Ohio, Nebraska and New York
  • Sleep Studies, Sleep Apnea Procedures and Surgeries for all lines of business (Excludes UnitedHealthcare Mid-Atlantic Health Plan, Neighborhood Health Partnership, River Valley, All Savers, Oxford and UnitedHealthcare West)
  • Site of Service for Office-based program and Outpatient Hospital for UnitedHealthcare commercial plans and UnitedHealthcare Community Plan. (Excludes UnitedHealthcare Mid-Atlantic Health Plan, Neighborhood Health Partnership, River Valley, All Savers, Oxford and UnitedHealthcare West)
  • Site of Service Reviews for Certain Surgical Procedures for UnitedHealthcare commercial plans and UnitedHealthcare Community Plan. (Excludes UnitedHealthcare Mid-Atlantic Health Plan, Neighborhood Health Partnership, River Valley, All Savers, Oxford and UnitedHealthcare West)
  • Electrical and Ultrasound Bone Growth Stimulators (Electromagnetic) and Hip Resurfacing and Replacement Surgery (Arthroplasty) for UnitedHealthcare Community Plan members
  • Hysterectomy for Benign Conditions and Implanted Electrical Stimulator for Spinal Cord for UnitedHealthcare commercial plans (Excludes UnitedHealthcare Mid Atlantic Health Plan, Neighborhood Health Partnership, River Valley, All Savers, Oxford, and UnitedHealthcare)

UHC will continue to add additional prior authorization service categories. For the latest service category launch dates, system functionality and training, access the insurer’s Interactive Guide for Prior Authorization and Notification Tool.

Source(s): UnitedHealthcare;

 

 

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