UHC - August 2021 Provider Bulletin and Informational Flyers

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