August 3, 2021
From United Healthcare, attached you will find the August 2021 bulletins and informational flyers.
August Network bulletin summary.
- Prior Auths
- Cardiovascular Prior Auths
- Prior Auth code updates for Commercial Plans
- Radiology therapy prior auths for Oxford – CT, NJ, NY
- West Region – Medical PRAs will not be mailed after October – AK, AZ,CA,CO,HI,ID,MT,NM,NV,OR,WA,WY
- Medicaid: New facet injection codes for prior auths – AZ, CA, MD,MO,MS,NJ,WI
- Additional Codes for early elective delivery – NJ
- Medicaid requirements for certain therapy services – NJ
Other Policies / Protocol Updates
- New outpatient injectable drug requirement – MD
- Prior auth and site of service updates – KY
- New states in-scope for naviHealth post-acute care – AR,DE,HI,ID,LA,MS,MO,NE,PE,UT,WV,WY
- Specialty Medical Injectable Drug program updates
- Medical Advantage 340b claims – Use JG modifier or attest to receive full payment
- On-demand webcast from OptumHealth
- Peer to peer request forms have moved
- Avoid claim denials for social determinants of health – AZ
- New state online appeals portal for Medicaid – VA
Medical & Reimbursement Policies Update Bulletins
