Medicare Advantage Radiology Prior Authorization Program

UHC will expand the scope of its radiology protocols to include Medicare Advantage Plans offered by SecureHorizons®, Evercare® and AARP® Medicare Complete®. Effective June 7, 2010, UHC will require all participating physicians who are subject to the UnitedHealthcare Administrative Guide to contact them to obtain prior authorization when ordering select advanced imaging procedures for Medicare Advantage members and subject to UnitedHealthcare Provider Administrative Guide.

The Radiology Prior Authorization Program includes CT scans, MRIs, MRAs, PET scans, and nuclear medicine studies, including nuclear cardiology.

Please note, that the following states with SecureHorizons and Evercare Medicare Advantage plans administered on and subject to the UnitedHealthcare Provider Administrative Guide are not participating in the program at this time: Connecticut, Idaho, Nebraska, New Jersey, Rhode Island, Oregon and Washington.

All other states are included in the June 7, 2010 effective date except Florida, which has an effective date of March 1, 2010.

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INDUSTRY NEWS TAGS: United Healthcare

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