United HealthCare (UHC) is updating its Advance & Admission Notification requirements for planned services. Effective April 1, 2012, physicians, healthcare professionals and ancillary providers will need to submit Advance Notification for more procedures than before. This includes both inpatient and outpatient services. Click here for access to the UHC Administrative Guide, which includes a complete list of procedures and services (beginning on page 20) that necessitate Advance Notification.
In addition, UHC is requiring facilities – like Northwest Community Hospital (NCH) – to confirm Advance Notification has been filed by the physician and that coverage is approved prior to the date of service. According to UHC, failure to comply with Advance Notification requirements will result in claims being denied in whole or in part. NCH is establishing a new process to communicate with physicians in the event Advance Notification is not on file when patients schedule service. More details will follow.Notification Process Remains the Same
The steps for submitting Advance Notification have not changed for physicians. Advance Notification is required at least five business days prior to the planned service date, unless otherwise specified within the UHC Advance Notification List. This can be completed online, by phone or fax.