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UHC updates policy guidance

UHC updates policy guidance

MINNETONKA, Minn. - UnitedHealthCare has released new guidance for HME providers as they respond to the COVID-19 outbreak, according to AAHomecare.

The new guidance, posted on its website, applies to Medicare Advantage, Medicaid, and individual and group market health plan members, for dates of delivery from March 31, 2020-May 31, 2020.

Changes include:

For all COVID-19 discharges to home-based care requiring a respiratory assist device or a ventilator, the vendor can deliver on notification only to UnitedHealthcare for codes E0471, E0465, E0466 and E0467 for up to three months from time of delivery. Notification is requested and the claim must be submitted with the appropriate modifiers and diagnosis code (ICD-10). After the three-month period, a prior authorization will be required.

For orders involving COVID-19-related oxygen requests, oxygen can be delivered without prior authorization and does not need to meet current clinical criteria.

The guidance extends certain prior-authorizations and allows for face-to-face exams by telehealth for new prior authorizations.

Allowing larger supply amounts for these disposable supply codes.

Relaxed proof-of-delivery requirements.


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