Tagged with UHC UnitedHealthcare
UnitedHealthcare Redesigns Emergency Department Reimbursement Policy
UnitedHealth Group has announced plans to introduce a new payment policy intended to reduce its emergency department claims cost.
UnitedHealthcare Laboratory Services Policy Revision
UnitedHealthcare (UHC) has made changes to its reimbursement policy for Laboratory Services affecting reference laboratories and non-reference laboratory physicians.
UnitedHealthcare Medicare Advantage Notification for Outpatient Injectable Chemotherapy
As of March 1 for UnitedHealthcare (UHC) Medicare Advantage (MA) members in Florida and Georgia and April 1 for plans in Wisconsin, UHC will require care providers to submit a notification for injectable chemotherapy when administrated in an outpatient setting for UHC MA members with a cancer diagnosis.
New Jersey – Site of Service Prior Auth. Requirements for Certain Procedures to Expand
For dates of service on or after April 1st, UnitedHealthcare is expanding notification/prior authorization requirements for certain services to be covered in certain sites of care to include commercial members in Indiana and New Jersey.
UnitedHealthcare – Changes in Advance Notification and Prior Authorization Requirements
Effective for dates of service on or after April 1st, several new codes will be added to UHC’s prior authorization list as a result of the American Medical Association (AMA) 2018 annual CPT® update.
UnitedHealthcare Prior Authorization and Coding Policy Updates
UHC has announced two updates for notification and prior authorization on certain procedures, as well as revisions to its emergency department facility evaluation and management (e/m) coding policies.
Florida Outpatient Injectable Chemotherapy Notification for UHC MA Plans
On March 1, 2018, UnitedHealthcare MA will require notification for injectable outpatient chemotherapy drugs given for a cancer diagnosis for members in Florida and Georgia.
UHC Medical Policy and Reimbursement Updates
UnitedHealthcare has released several policy and reimbursement updates that will take effect on December 1, 2017.
UHC Genetic and Molecular Lab Testing Prior Authorization Requirement
Beginning November 1, UnitedHealthcare (UHC) will require a new online notification/prior authorization process for genetic and molecular lab tests for their Commercial benefit plan members.
UHC – Genetic and Molecular Testing Prior Auth. Requirement
Effective Nov. 1, UnitedHealthcare will start its online prior authorization/notification program for genetic and molecular testing performed in an outpatient setting for fully insured UnitedHealthcare Commercial Plan members. Providers requesting laboratory testing will be required to complete the prior auth. process as well as indicate the laboratory and test name for specific services.
UnitedHealthcare Expands Prior-Authorization Requirement for Certain Office-Based Procedures Performed in Other Sites of Service
Beginning October 1, UnitedHealthcare will require notification/prior authorization for certain procedures when performed in any setting other than a physician’s office.
NY – Insurers seeking Double-Digit Rate Increases
New York health insurers are seeking premium rate increases averaging 16.6% in the individual market and 11.5% in the small group market for 2018.
IL – Blue Cross Blue Shield Awaits State Review
For the first time since 1990, the Illinois Department of Insurance will conduct a broad market examination of Blue Cross and Blue Shield of Illinois to see how the insurer treats its customers in compliance with consumer protection regulations.
MA – OptumHealth to Acquire Reliant Medical Group
OptumHealth, a subsidiary of UnitedHealthcare, has announced plans to acquire Reliant Medical Group, a physician group out of Massachusetts. The acquisition represents Optum’s first venture into the state’s provider market.
CT – State Insurers Request Rate Increases on Individual and Group Plans
Health insurers in Connecticut have submitted health insurance rate request individual and small group plans in 2018. A total of 10 health insurance companies have made 14 filings on individual and small group plans that provide coverage to approximately 270,000 people in the state. The average rate requests range from 3.6% to 33.8%.
UnitedHealth Announces Plans to Shut Down Free-of-Charge Primary Care Startup
UnitedHealth Group has announced plans to shut down its subsidiary insurance startup which offered unlimited primary and behavioral care at no charge.
Aetna to Exit all ACA Insurance Marketplaces in 2018
Aetna has announced plans completely withdraw from the ACA insurance exchanges for 2018, citing financial losses as the deciding factor, specifically its individual commercial products lost nearly $700 million between 2014 and 2016 and could lose another $200 million this year.
Unitedhealth Posts Strong Earnings Growth in First Quarter
United Healthcare reported first-quarter revenues of $48.7 billion – a 9.4% year-over-year increase from last year. The insurer says that due to 3% insurance tax in Affordable Care Act, plan premiums will likely rise in 2018.
Justice Department Discloses False Claims Act Investigation into Multiple Payers
The U.S. Justice Department recently disclosed that there will be an investigation into four more major health insurers as part of a False Claims Act lawsuit filed against UnitedHealth Group in 2011.
