UnitedHealthcare to issue new Premium Designation physician results In its June Network Bulletin, UnitedHealthcare (UHC) announced that the next iteration of its Premium Designation assessment results will be sent to physicians in early July. These results will be released publicly via the payor's online physician directory beginning September 6, 2017. Physicians within 16 specialties (allergy, cardiology, ENT, endocrinology, family medicine, gastroenterology, general surgery, internal medicine, nephrology, neurology, neurosurgery, OB/GYN, pediatrics, pulmonology, rheumatology and urology) and their 46 credentialed sub-specialties will again be ranked by UHC on both national and specialty-specific measures for quality and various cost-efficiency benchmarks. UHC says ... July 21, 2017 Managed Care United Healthcare 0 0 Comment Read More »
United Healthcare delays 2016-2017 Premium Designation physician results United Healthcare (UHC) has indicated that distribution of its 2016-2017 Premium Designation assessments will be delayed to December 30, 2016, with the results released to the public on March 1, 2017. UHC had previously announced that the next iteration of its Premium Designation assessment results would be sent to physicians in early November 2016, with the results to be released publicly via the payor's online physician directory on January 4, 2017. Physicians who encounter problems with their physician assessment reports or who have concerns regarding their Premium Designations can ... December 21, 2016 Managed Care United Healthcare 0 0 Comment Read More »
United Healthcare to introduce Navigate, new narrow network product, in 2017 United Healthcare (UHC) recently notified physicians that it will be introducing a new commercial narrow network PPO product, Navigate, to the California marketplace effective January 1, 2017. Due to an operational error, the notice issued to California providers inadvertently referenced United Healthcare of Nebraska, which is also launching the Navigate product. UHC has since issued a corrected notice. UHC says the Navigate plan is its most recent effort at providing a reduced-cost health care option to employers. This network offers access to a significantly narrowed network of PPO physicians, ... December 14, 2016 Managed Care United Healthcare 0 0 Comment Read More »
United to issue new 2016-2017 Premium Designation physician results In its October Network Bulletin, United Healthcare (UHC) announced that the next iteration of its Premium Designation assessment results will be sent to physicians in early November. These results will be released publicly via the payor's online physician directory beginning January 4, 2017. Physicians within 16 specialties (allergy, cardiology, ENT, endocrinology, family medicine, gastroenterology, general surgery, internal medicine, nephrology, neurology, neurosurgery, OB/GYN, pediatrics, pulmonology, rheumatology and urology) and their 47 credentialed sub-specialties will again be ranked by UHC on both national and specialty-specific measures for quality and various cost-efficiency benchmarks. ... November 16, 2016 Managed Care United Healthcare 0 0 Comment Read More »
Physicians encouraged to verify CHPI data by November 11 Earlier this month, approximately 13,000 physicians in California received their individual quality measurement scores for the second cycle of the California Healthcare Performance Initiative System (CHPI) quality rating program. Physicians can review and verify the accuracy of the data used to calculate their scores through the CHPI online portal through November 11, 2016. The program rates physicians using claims data from Medicare fee-for-service, Anthem Blue Cross, Blue Shield of California and United Healthcare. This claims data includes both commercial and self-funded health plan data from HMO, PPO, POS and Medicare ... September 22, 2016 Managed Care, Medicare Medicare, Quality of Care, United Healthcare, Anthem Blue Cross, Blue Shield, CHPI 0 0 Comment Read More »
United Healthcare fails to provide proper notification on rollout of clinical data submission protocol The California Medical Association (CMA) is concerned that United Healthcare (UHC) failed to properly notify physicians before implementation of its Clinical Data Submission Protocol. Although California law (California Insurance Code §10133.65 and Health & Safety Code §1375.7) requires payors to provide contracted physicians with the 45 business days’ advance notice of any material contracting changes, UHC's only notification to physicians about this new protocol was in its Network Bulletin. First introduced in 2015, the program originally targeted only Medicare benefit plans and required physicians to submit all laboratory test ... September 13, 2016 Managed Care, Medicare United Healthcare, Medicare 0 0 Comment Read More »
UHC to require prior authorization for select outpatient surgical procedures As indicated in its July 2015 Network Bulletin, United Healthcare (UHC) will begin requiring prior authorization for certain surgical procedures done in a hospital outpatient setting effective October 1, 2016. The new prior authorization requirement includes procedure codes in cardiovascular, cosmetic and reconstruction, ophthalmology, and ENT (ear, nose and throat) specialties. Prior authorization will not be required to perform the identified procedures if done in an in-network ambulatory surgery center. For a complete listing of procedures requiring prior authorization, physicians can access the Prior Authorization for Outpatient Surgical Procedures FAQ ... August 9, 2016 Managed Care United Healthcare, Preauthorization 0 0 Comment Read More »
United Healthcare extends clinical data submission deadline to Sept. 2 At the request of the California Medical Association (CMA), United Healthcare (UHC) has delayed the expansion of its Clinical Data Submission Protocol in California. Originally scheduled to take effect July 1, the expansion will now be pushed back until September 2. First introduced in 2015, the program originally targeted only Medicare benefit plans and required physicians to submit all laboratory test results for UHC Medicare patients. The expansion of the program will require practices to submit laboratory tests for all UHC Medicaid and commercial benefit plans. For more information about ... July 14, 2016 General Medicare, United Healthcare, Clinical Laboratories 0 0 Comment Read More »
United Healthcare to post patient satisfaction ratings in provider directory United Healthcare (UHC) announced in its March 2016 Network Bulletin that it has incorporated Healthgrades patient satisfaction ratings into its provider directory search tool on its myUHC.com website. Healthgrades is an independent company that allows patients to rate their satisfaction with their health care providers. UHC reports it is incorporating the patient satisfaction ratings into its provider directory to increase patient awareness and education regarding patient satisfaction and quality of care standards. Patients will rate providers – including physicians, nurse practitioners and physician assistants – on their satisfaction level for each ... April 12, 2016 General United Healthcare 0 0 Comment Read More »
UHC to require prior authorization for select musculoskeletal and pain management procedures As indicated in its January 2015 Network Bulletin, United Healthcare (UHC) will begin requiring prior authorization for certain additional musculoskeletal and pain management procedures effective April 4, 2016. Included in the new prior authorization requirement are various arthroscopy procedures, spine-related surgeries, neurostimulators for back pain and certain foot surgical procedures. For a complete listing of procedures requiring notification, physicians can access the Advance Notification Requirements on the UHC website. Prior authorization will be required for services performed in all places of service settings, including inpatient/outpatient hospitals, ambulatory surgery centers ... February 9, 2016 General, Managed Care Preauthorization, United Healthcare, Pain Medicine 0 0 Comment Read More »
