Posted in Pharmacy (Various Insurance Payers), Training, Updates

NY/CA UHC CommunityHealthPlan: updated info for Xolair and Synagis auth, 04/01/2021

Starting 04/01/2021- the providers will need to request an authorization for Xolair and Synagris if they plan on billing through patient medical benefit. (Community Health Plan)

This change applies to providers in CA and NY (community health plans).

These requirements will apply whether members are new to therapy or have already been receiving these medications.

UHC will honor existing authorizations for Xolair until the end date on the authorization or the date the member’s eligibility changes.

Providers don’t need to submit a new prior authorization request for members who already have an authorization for Xolair on April 1, 2021.

You can submit prior authorization requests in the following ways:

  • Online: Use the Prior Authorization and Notification tool on Link. Go to UHCprovider.com/paan.
  • Call: Use the Provider Services phone number on the member’s health care identification card.

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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