UnitedHealthcare Waives Cost Sharing, Extends Telemedicine for Certain Plans
By Ellen Terry

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UnitedHealthcare (UHC) is waiving cost sharing for Medicare Advantage plan members for primary care services through Dec. 31. This applies to in-network and covered out-of-network COVID-19 and non-COVID-19 visits, whether they are conducted in office or via telemedicine. 

UHC also 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. 

See below for telemedicine coverage extensions for specific plans. 

For Medicare Advantage:  

  • As of Jan. 1, UHC covers certain in-network and out-of-network telemedicine visits (both COVID-19 and non-COVID-19) through the national public health emergency.   

For individual and fully insured group market plans:   

  • As of Jan. 1, UHC covers certain in-network telemedicine services (both COVID-19 and non-COVID-19) indefinitely;
  • UHC covered out-of-network telemedicine COVID treatment until Oct. 22, 2020;
  • Out-of-network COVID testing telemedicine visits are covered from Jan. 1, 2021, to the end of the public health emergency.   

Find more information on UHC’s COVID-19 Teleheath page, and visit UHCprovider.com/covid19 for telehealth billing guidance. 

In addition, UHC has updated its Telehealth and Telemedicine Policy for next year. Effective with dates of service on and after Jan. 1, 2021: 

  • UHC will consider for payment only telehealth services reported with place of service (POS) 02, in conformance with Centers for Medicare & Medicaid Services guidelines. You may append modifiers 95, GT, GQ, or GO to telehealth claims reported with POS 02, but the modifiers will be considered informational and not necessary to identify telehealth services.
  • UHC will consider the health plan member’s home as an originating site for eligible services.
  • Codes listed in the current policy will be eligible for consideration, as well as similar types of services rendered using interactive audio and video technology. 

Below are other changes UHC announced recently.

New Process to Track Drug Coupons:

On Jan. 1, UHC launched a program to help align employer specialty medical drug costs with members’ out-of-pocket costs and deductibles. The Accumulator Adjustment Medical Benefit program for commercial plans will require you, through a two-step process, to submit member cost-share payment information, received from drug manufacturers when coupons or copay cards are submitted for specialty medical drug claims. Read these FAQs about the program. 

UHC Going Paperless:

This fall, UHC will begin to transition provider remittance advices, all clinical and claim letters,  and hospital admission notifications from mail to Document Vault in Link, UHC’s gateway to self-service tools. The paperless rollout will continue in 2021 as UHC transitions paper claims, claim attachments, and medical records to digital channels. 

You can sign up for paperless delivery now (see this quick reference guide for instructions). Most letters for claims, prior authorization, and payments are already in Document Vault. 

These letters are available the same day they are generated, which is considered the date sent.

 

Last Updated On

June 16, 2021

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Ellen Terry

Project Manager, Client Services

(512) 370-1391

Ellen Terry has been writing, editing, and managing communication projects at TMA since 2000. She hails from Victoria, Texas; has a journalism degree from Texas State University; and loves to read great fiction. Ellen and her husband have two grown sons and a couple of cats.

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