Fierce Healthcare August 6, 2024
UnitedHealthcare will launch a national program Oct. 1 for physicians to override traditional prior authorization requirements.
The gold card program, which applies to commercial, individual exchange and Medicare Advantage plans, allows certain physician practices to not submit prior authorization requests for “certain medical, behavioral and mental health services,” according to a fact sheet released by the company.
Instead, practices that earn gold card status must fill out a simple advance notification to confirm member eligibility and coverage for services.
To be eligible for gold card status, practices must show a prior authorization approval rate of 92% or higher for two consecutive years.
“The UnitedHealthcare Gold Card program is the next step in our continual efforts to modernize the prior authorization...
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