Tagged with UHC UnitedHealthcare

UnitedHealthcare Requiring Hospital Outreach Labs to Contract as Independent Reference Labs

Effective May 1, UnitedHealthcare (UHC) will deny any non-patient lab test claims submitted by hospital outreach labs if billed under the hospital’s facility participation agreement. The insurer is requiring that hospital outreach labs are credentialed and contracted as an independent reference lab in order to get their non-patient lab test claims paid.

UHC Issues New ED Professional E/M Policy

UnitedHealthcare (UHC) has announced that starting April 1, 2020, they will use a proprietary software program to evaluate all professional claims submitted for emergency department visits with the Level 5 evaluation and management (E/M) code 99285.

UHC Radiology Program Procedure Code Changes

Effective January 1, UnitedHealthcare (UHC) will update the procedure code list for the Radiology Notification and Prior Authorization programs based on code changes made by the American Medical Association (AMA). Claims with dates of service on or after January 1 are subject to these changes.

UHC Medical Policy Updates

UnitedHealthcare (UHC) has released its 2020 Summary of Changes to Advance Notification and Prior Authorization Requirements.

UnitedHealthcare Medical Policy Updates

UnitedHealthcare (UHC) has released its most recent medical policy updates for November 2018 which includes complete details on UHC medical policy, medical benefit drug policy, coverage determination guideline), utilization review guideline, and/or quality of care guideline updates, as well as new, updated, revised, replaced and retired health services policies.

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