N.A. professional restrictions (as In cases of clinical questions, try to applicable) select the best answer based upon If form/web page asks for clinical Site provides a very long, small-font the information contained in the information, either offer check list list of possible answers from which to clinical notes, selection of appropriate clinical choose. Met If auto-approved, enter the auth information or allow provider to number and date of service ranges submit ALL clinical information See website #8f comment. into the EHR, and/or take a screen relevant to the specific request for services, and not restrict provider from sending this relevant information for submission of form Some supporting information can be electronically or faxed with cut and pasted into the request form. supporting documentation Up to a single 5 MB word document Met can be uploaded Uploaded and faxed documents are not always by UHC. “received’ Provide an acknowledgement Met Either an authorization number (if receipt of the review request auto-approved) or a case number Able to print the completed request form and/or review online the information submitted on the request. Perform review for ALL submitted For a number of Unlisted Procedures, services that are valid per the BPR, the site will not confirm the not just those requiring a description for the CPT code. A call authorization -- including Unlisted to UHC must be made to make the Procedures, except for those listed request. on health plan website. Met Perform review without a provider signature on the request
In cases of clinical questions, try to select the best answer based upon the information contained in the clinical notes, If auto-approved, enter the auth number and date of service ranges into the EHR, and/or take a screen authorization professional restrictions (as applicable) N.A. If form/web page asks for clinical information, either offer check list selection of appropriate clinical information or allow provider to submit ALL clinical information relevant to the specific request for services, and not restrict provider from sending this relevant information Met Site provides a very long, small-font list of possible answers from which to choose. See website #8f comment. for submission of form electronically or faxed with supporting documentation Met Some supporting information can be cut and pasted into the request form. Up to a single 5 MB word document can be uploaded Uploaded and faxed documents are not always “received’ by UHC. Provide an acknowledgement receipt of the review request Met Either an authorization number (if auto-approved) or a case number Able to print the completed request form and/or review online the information submitted on the request. Perform review for ALL submitted services that are valid per the BPR, not just those requiring a -- including Unlisted Procedures, except for those listed on health plan website. For a number of Unlisted Procedures, the site will not confirm the description for the CPT code. A call to UHC must be made to make the request. Perform review without a provider signature on the request Met
UHC-CP%20Detail%201.docx