United HealthCare

United Walks Back Payment Cut on Nonphysician Billing - 08/05/2021

Following strong pushback from the Texas Medical Association, UnitedHealthcare (UHC) has effectively reversed its payment-cutting policy change on “incident-to” billing for services performed by nonphysician practitioners (NPPs). 

UnitedHealthcare Waives Cost Sharing, Extends Telemedicine for Certain Plans - 06/16/2021

UnitedHealthcare is waiving cost sharing for Medicare Advantage plan members for primary care services, and has extended access to in-network and out-of-network telemedicine visits, including COVID-19 testing and treatment, until Dec. 31 for most of its plans.

Did You Subscribe to UHC’s Premium Payment Program? Check By March 31 - 03/29/2021

TMA reminds practices that now is a good time to determine whether you are enrolled in UnitedHealthcare’s (UHC) Optum Pay Premium program, which charges a fee for access to certain electronic data. Physicians and practices who wish to opt out of the program should do so by March 31.

UHC Postpones Higher Liability Coverage Requirements Plan - 12/11/2020

UnitedHealthCare (UHC) postponed a plan that would require Texas physicians to substantially increase their professional liability insurance coverage in order to participate in its networks. The move comes after the Harris County Medical Society and Texas Medical Association expressed serious concerns about the new policy.

Revised UnitedHealthcare E&M, Prior Auth Procedures to Take Effect Jan. 1 - 12/09/2020

The Texas Medical Association’s reimbursement specialists want to be sure you see the following items in the UnitedHealthcare (UHC) December bulletin.

Collecting Payment for Noncovered Services - 10/15/2020

Can you charge a patient for a service the patient’s health insurance plan doesn’t cover? Answer: It depends.

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.

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.

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).

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.

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.

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.

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.

Use Health Plan Policies to Avoid Denied Claims - 04/19/2018

Coverage policy, medical policy, clinical policy, reimbursement policy … health plans’ policies are the guidelines they use to help decide what services and procedures they consider medically necessary and how they will — or will not — pay for them.