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UnitedHealthcare's prior authorization removals just 'payer antics,' surgeons say

By Admin | November 01, 2023

Nov. 1 marks a new wave of prior authorization code eliminations from UnitedHealthcare, which announced plans to drop prior authorization requirements by 20% in August. 

On Sept. 1, the payer began phase one of its two-phased approach to eliminating prior authorization requirements for several procedure codes, accounting for 20% of its overall volume. 

During stage one, codes were eliminated for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plans.

As of Nov. 1, codes will be eliminated for UnitedHealthcare Community Plan holders as well. Four spinal surgery codes and three orthopedic surgery codes were cut from prior authorization requirements, but so far, surgeons have not seen any real benefit from the removals. 

In fact, the codes that were removed are some of the least utilized in musculoskeletal care. Now, surgeons are accusing UHC of removing codes for show, knowing they will have no...(More)

For more info please read, UnitedHealthcare's prior authorization removals just 'payer antics,' surgeons say, by Beckers Orthopedic Review

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