UnitedHealthcare updates home health prior authorization review process

UnitedHealthcare is updating its prior authorization and concurrent review process for home health services that are delegated to Home & Community Care, the payer's home care division. 

The changes take effect Jan. 1 and affect Medicare Advantage and Dual Special Needs plans, according to a Nov. 27 policy update from the payer. 

Here are four things to know:

  1. Start of care visits still do not require prior authorization. 
  2. Providers must notify Home & Community Care of the initiation of home care services. UnitedHealthcare encourages providing notice within five days after the start of a care visit to help avoid potential payment delays. 
  3. Before the 30th day, providers must request prior authorization for days 30 to 60, by discipline, and provide documentation to Home & Community Care.     
  4. For each subsequent 60-day period, providers must request prior authorization, by discipline, and provide documentation to Home & Community Care during the 56- to 60-day recertification window.  

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months