UnitedHealthcare updates telehealth place-of-service billing requirement - California Medical Association

-
April 14, 2021
Area(s) of Interest: Payor Issues and Reimbursement 

UnitedHealthcare (UHC) is now requiring physicians to bill eligible telehealth services with place of service (POS) 02 for commercial products. Telehealth claims with any other POS will not be considered eligible for reimbursement.

While the policy – announced in United's October 2020 Reimbursement Policy Update Bulletin – became effective January 1, 2021, UHC advises that an unofficial transition period for payment of claims not billed with POS 02 was in place through mid-March. Effective March 13, 2021, telehealth claims not billed with POS 02 will not be paid and providers will be required to resubmit a corrected claim.  

The change implemented by UHC aligns with the California Department of Managed Health Care (DMHC) all plan letter (APL) issued on September 4, 2020, which reminded DMHC-regulated health plans of the continued requirement to reimburse providers at the same rate for telehealth services, including telephonic visits, as they would for services provided in person. This APL clarified that the prior APLs (20-009 and 20-013) remain in effect for the duration of California's declared state of emergency or until further notice from DMHC, whichever is earlier. The APL also clarified that these requirements apply to delegated entities to the extent the health plan delegated the services impacted by these APLs.

On March 30, 2020, the California Department of Insurance (CDI) issued guidance requiring CDI-regulated insurance companies to reimburse providers at the same rate for telehealth services as they would for services provided in person. Insurers were also required to reimburse a service provided telephonically at the same rate as services provided via video. These requirements are in effect throughout the declared COVID-19 state of emergency.  

For more information see: UnitedHealthcare Telehealth Services: Care Provider Coding Guidance.

Return

Comments

Post a Comment

Popular posts from this blog

Силы специальных операций будут выполнять задачи как за ...

-
Image
clindamycin gel pregnancy :: Article Creator Maternal Vs. Fetal Rights Forcing Pregnant Women to do as They're Told:Maternal vs. Fetal Rights By Claire Andre and Manuel Velasquez Janet Rowen may be incarcerated because she is pregnant. Her doctor, Marion Smyth, thinks Janet drinks too much alcohol and has repeatedly advised her of the risks her drinking poses to the child she has chosen to have. Heavy alcohol use during pregnancy can result in "fetal alcohol syndrome." Infants with this syndrome suffer from mental retardation and physical deformities and have an increased chance of dying shortly after birth. Janet is unwilling to cut down on her drinking. Dr. Smyth is seeking a court order that would incarcerate Janet for the duration of her pregnancy, forcing her to follow Dr. Smyth's medical advice. Research in medicine continues to reveal more and more ways in which a baby's health can be jeopardized by what a woman doe...
Read more

Providence says it offered to manage API before state awarded no-bid contract to Wellpath - Anchorage Daily News

-
Image
Alaska health care giant Providence Health and Services made overtures to the state about taking over management of the troubled Alaska Psychiatric Institute before a lucrative no-bid contract was awarded to Wellpath , a Tennessee-based company that sprouted from the private prison industry, a letter between hospital executives and lawmakers shows. In early February, Wellpath was awarded a roughly $43 million-per-year contract to operate API, the state’s only psychiatric hospital. State officials declared an emergency and circumvented the usual government procurement rules, saying the hospital was unsafe and about to lose federal funding. Ever since, questions about how the deal came together have dogged state health officials. Some lawmakers, like Rep. Ivy Spohnholz, an Anchorage Democrat, have asked why in-state providers like Providence were not considered. “Given that Providence has been operating in Alaska since 1902 and has a proven track record providing in-patient p...
Read more