Complete Story
12/14/2023
United Healthcare
United Healthcare Managed Care Committee Member
Shelby Jensen, CHONC - Newland Medical Associates
General
You can access the Medical Benefit Specialty Drug Update Bulletin for the latest updates on drugs added to review at launch, program requirements, and policies. Click through for complete details.
Neighborhood Health Partnership
Neighborhood Health Partnership prior authorization reduction
Prior authorization will no longer be required for observation admissions.
Starting Jan. 1, 2024, UnitedHealthcare Neighborhood Health Partnership will remove the prior authorization requirement for observation admissions. We’re making this change to help simplify the health care experience for our members and network health care professionals.
You will still need to submit notification for inpatient admissions, but you’ll no longer need to obtain prior authorization for observation level of care.
Learn more
See the full list of codes that require prior authorization for UnitedHealthcare Neighborhood Health Partnership members. We’ll update this list before Jan. 1, 2024, to reflect the prior authorization removal for observation admissions.
Chat with a live advocate 7 a.m.–7 p.m. CT from the UnitedHealthcare Provider Portal. You can also call Provider Services at 877-842-3210, TTY/RTT 711, 7 a.m.–5 p.m. CT, Monday–Friday.
Advance Prior Authorization Requirements for Neighborhood Health Partnership
Updates to this list are announced regularly in the UnitedHealthcare Network News. For more information, please call NHP Management at 877-842-3210.
To request advance prior authorization, please submit your request online, or by phone.
- Online: Use the Prior Authorization and Notification app on UnitedHealthcare Provider Portal. Go to UHCprovider.com and click on the UnitedHealthcare Provider Portal button in the top right corner. Then, select the Prior Authorization and Notification app tile on your Provider Portal dashboard.
• Phone: 877-842-3210
Advance prior authorization is not required for emergency or urgent in- and out-of-area care. Out-of-network physicians, facilities and other health care providers must request prior authorization for all procedures and services, excluding emergent or urgent care.
Advance prior authorization is required for the following procedure and service categories for all NHP plan members in both outpatient and inpatient settings, unless otherwise noted.
UHC Commercial
UHC Community Plan
UHC Medicare Advantage
UHC Individual Exchange
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