COVID-19 Prior Authorization and Ongoing Patient Care Updates

Last update: March 25, 2020, 11:15 p.m. CDT

UnitedHealthcare is working to help people access health care to the fullest extent possible as we come together to address this national emergency. We’re adopting measures that will reduce administrative burden for physicians and facilities, helping members more easily access the care they need under their benefit plan, and adjusting programs and services, as needed, to protect members and help limit the spread of the COVID-19 virus in communities.

Prior Authorizations

The following prior authorization provisions are effective March 24, 2020:

  • Suspension of prior authorization requirements to a post-acute care setting through May 31, 2020. Details:
    • Waiving prior authorization for admissions to: long-term care acute facilities (LTAC), acute inpatient rehabilitation (AIR), and skilled nursing facilities (SNF).
    • Consistent with existing policy, the admitting provider must notify us within 48 hours of transfer – penalties still apply.
    • Length of stay reviews still apply, including denials for days that exceed approved length.
    • Discharges to home health will not require prior authorization.
    • Prior authorization is not required for COVID-19 testing and COVID-19 testing related visits.
    • UnitedHealthcare is able to help providers with patient discharge planning to lower levels of care settings. Please email COVID-19dischargeplanning@uhc.com for assistance.
  • Suspension of prior authorization requirements when a member transfers to a new provider through May 31, 2020. Details:
    • Providers are not required to submit a new prior authorization when a member moves to a different yet similar site of care for the same service (e.g., hospital transfers or practice transfers).
    • Consistent with existing policy, the admitting provider must notify us within 48 hours of transfer so that the existing authorization can be transferred. Penalties still apply.
  • Suspension of review for site of service until April 30, 2020 for the surgical codes listed here.

And, we may temporarily suspend or relax additional policies as needed in regions where inpatient capacity is most compromised and at risk. Please watch for this site for additional updates.

Systems are being updated to reflect these changes. We are also developing an FAQ with additional information, which includes details about some states that may have different prior authorization requirements. Please check back often for the latest information.


Home Health Billing to Go, Inc. is now offering
full service PCR Clinical Review. Service includes:
Review of clinical record for PCR compliance,
submission of PCR request and/or billing services.
Please contact us at
pcrinfo@homehealthbillingtogo.com
for additional information.