UnitedHealthcare’s COVID-19 Response – Update
Throughout the public health emergency (currently set to end on January 20, 2021), UHC is extending the cost share waiver for COVID-19 in-network telehealth services. UHC will also waive cost share for COVID-19 treatment until December 31, 2020. For out-of-network services, the cost share for COVID-19 testing will be waived until January 20, 2021 and treatment until October 22, 2020. The cost share waiver for in-network, non COVID-19 telehealth services ended September 30, 2020.
UnitedHealthcare is not enforcing referral requirements for Medicare Advantage plans throughout the national public health emergency. For Medicaid, Individual and Group Market health plans, the standard referral requirements will apply. No referral is needed for emergency care. Please keep in mind that Florida, Rhode Island and Maryland have state requirements.
COVID-19 Testing and Treatment
UnitedHealthcare is waiving cost share for in-network and out-of-network testing and treatment until the end of the public health emergency for Individual, Group Market Health Plans and Medicare Advantage plans. For Medicaid plans, state regulations apply. Medically necessary diagnostic testing for both the virus and antigen will be covered when ordered by a physician or other licensed healthcare professional. Testing for the purposes of employment, education, public health or surveillance will be covered and adjudicated in accordance with the member’s benefit plan.
Primary Care Processional Services & Other Office-Based Professional Services
For Medicare Advantage plans, cost share was waived until September 30, 2020. Effective October 1, 2020, visits will be adjudicated in accordance to the member’s benefit plan.
Timely Filing Extensions
For Individual and Group Market Health Plans, timely filing requirements will be extended 60 days following the last day of the National Public Health Emergency. For Medicare Advantage and Medicaid plans, timely filing requirements will remain the same unless the Centers for Medicare & Medicaid Services issue updated guidelines. Medicaid state-specific rules and other regulations may apply, so please refer to your state-specific website.
For any additional information, please visit UHCprovider.com/covid19.
Physicians Group Management (PGM) is one of the fastest-growing medical billing companies in the United States. For over 35 years, PGM has been providing medical billing and practice management services and software to physicians, healthcare facilities, and laboratories. PGM’s current client base encompasses the full spectrum of medical specialties, including Internal Medicine, Dermatology, Plastic & Reconstructive Surgery, Pathology, EMS & Ambulatory Services, Cardiology, Nephrology, Urology, Pain Management, OB/GYN, Gastroenterology, Independent Laboratory, and many more. PGM’s medical billing and practice management solutions include:
– A full suite of practice management and medical billing solutions each tailored to the specific needs of your practice
– CCHIT-certified electronic medical record software and services
– Streamlined, customized credentialing services for providers of all sizes
– Practice management software that provides advanced financial and practice analysis tools, specifically designed to give enhanced visibility of operations at the click of a button
– Laboratory billing software that offers best-in-class systems to streamline, and manage and track, financial and administrative processes