Beginning October 1, 2024, UnitedHealth Group is launching a “gold card” program for provider organizations that are in-network for at least one UnitedHealth Group line of business. The goal of the program is to modernize and streamline the prior authorization process.
UnitedHealth said the program is intended to help physicians override prior authorization requirements to more quickly deliver care to consumers enrolled in a UnitedHealth insurance plan. Under the program terms, approved physician practices will be exempt from submitting prior authorization requests for certain medical and mental health services.
To be eligible for the “gold card,” a practice must meet three criteria: in-network for at least one UnitedHealth Group plan, a prior authorization approval rate of 92% or higher for at least the past two years, and a minimum of 10 requests per year. Practices must file a notice of advance eligibility before consumers receive care for covered services.
UnitedHealth said consumers covered under its Medicare Advantage plans are eligible to receive care and accelerated approval under the “gold card” plan. It will also include members with other forms of insurance, so long as they are using their plan in-network.
No application is required for a practice to participate in the “gold card” program. UnitedHealth said it will notify physicians through their portal if they meet the requirements.
This was reported by UnitedHealthcare on September 4, 2024. Accessed September 9, 2024.
Contact information: Will Shanley, Media Contact, UnitedHealthcare, 9900 Bren Rd. E, Ste 300W, Minnetonka, MN, 55343-4402; 714-204-8005; Email: will.shanley@uhc.com; Website: https://www.uhc.com/
November 2024 00US24EUA0065