United HealthCare

UnitedHealthcare Out-of-Network Referrals: Prior Approval, Patient Consent - 02/05/2020

If you are a UnitedHealthcare (UHC) participating physician referring a patient out of network in a nonemergency, you’re now required to first obtain either (1) prior approval from UHC; or (2) the patient’s written consent.

United Healthcare Cuts Consults - 09/04/2019

United Healthcare is eliminating payment for consults in two phases – one that took effect June 1 for certain services, and their complete elimination starting in October. The change is an effort to align with the Centers for Medicare & Medicaid Services policy that eliminated payment for most consults in 2010, but it’s going to make it more difficult for many specialists to get compensated for the extra time and work those services require.

Coding Changes Affect UnitedHealthcare Prior Authorization Lists - 02/22/2019

UnitedHealthcare (UHC) has replaced and added procedure codes on its notification and prior authorization (PA) lists.

New UnitedHealthcare Automated Services Can Save You Time - 11/13/2018

UnitedHealthcare says it has made it easier for you to submit records, have claims paid sooner, and access pharmacy benefit information.

United to Add Lab, Change Lab and Other Policies - 10/04/2018

Starting Jan. 1, 2019, UnitedHealthcare will use Quest Diagnostics, in addition to LabCorp, as in-network laboratories for all UHC members (excluding existing lab capitation agreements).

United Makes Changes to After-Hours Policies - 06/28/2018

Here's some news you can use from UnitedHealthcare.

United Healthcare Lab Policy to Change — Payer Newsletter Excerpt - 04/27/2018

Starting June 1, prepare for a change to the United Healthcare Laboratory Services Policy regarding who can report duplicate laboratory services.

Private Payer Roundup, January 2015 - 04/27/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about drug formulary changes, coding tips, a prior authorization change, and more.

Payer Roundup, January 2017 - 04/27/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about new preauthorization and payment policies, an evaluation and management code review — and a letter you may get from Novitas Solutions.

Private Payer Round-Up, March 2013 - 04/27/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists.

Private Payer Round-Up, May 2014 - 04/26/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists.

Private Payer Roundup, November 2016 - 04/26/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out what policy and other changes payers are rolling out for 2017.

UHC Termination Date Correction, BCBSTX EFT Error - 04/20/2018

When checking eligibility for HealthSelect of Texas (Employees Retirement System) members, practices may see two lines of coverage.

UnitedHealthcare Sends Out Performance Reports - 04/20/2018

UnitedHealthcare sends performance reports to outlier network physicians. Be sure to read yours, if you get one, comment if needed, and watch for coming changes.

Private Payer Roundup, July 2016 - 04/20/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about a tiering and rating designation change, and a new TMA tool to help fight inadequate payer networks.

Private Payer Update, June 2012 - 04/20/2018

  In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists (June 2012).

Payer Roundup, January 2016 - 04/19/2018

TMA’s reimbursement specialists give you a heads up and suggestions regarding some insurance hassles; also, find out about preauthorization changes, and new Medicare drug testing codes.

Private Payer Roundup, August 2015 - 04/19/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about new forms to use, new data you need to submit, new payment policies, and more.

Payer Roundup, March 2015 - 04/19/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. This month, we’ve included Medicare updates from Novitas Solutions, along with information from private payers.

Private Payer Round-Up, April 2014 - 04/19/2018

In case you missed these — here is a roundup of useful items from health care payment plans' newsletters and updates, compiled by TMA's reimbursement specialists.

Private Payer Roundup, July 2015 - 04/19/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about network terminations, ICD-10 testing, coding tips, and more.

Payer Roundup, September 2016 - 04/19/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ and Medicare’s newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about a new modifier rule, billing and coding changes and rules, and new tools from payers.

Private Payer Roundup, October 2016 - 04/19/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out changes affecting some Medicare Advantage plans, a new National Drug Code policy, and a pilot program coming to Texas.

Payer Roundup, April 2017 - 04/19/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about a possible audit request, new precertification requirements and more.

Pass-Through Billing Generally Not Permitted - 04/19/2018

Pass-through billing occurs when an ordering physician requests a service and bills insurance for it but does not perform the service. Insurance companies generally forbid this practice.