UHC to require prior authorization for select musculoskeletal and pain management procedures

February 04, 2016
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement Practice Management 

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 and office locations. Practices may submit prior authorization requests to UHC via the www.UnitedHealthcareOnline.com website, by calling (877) 842-3210 or by faxing the request to (866) 756-9733.

For questions or concerns regarding this process, physician practices should contact UHC Network Management at (866) 574-6088.


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