Posted in #unitedhealthcare, NY Providers, Payer Updates, Training

UHC NY Community Plan Referral requirement change-effective immediately

As per UniteHealthCare- NY community Plan -members will no longer require referrals to see specialists (most specialties).


This change is made to help Primary Care Physicians with reducing administrative burden and make it easier for the members to see some specialists.

The specialists that do or do not require a referral still need to be In Network with UHC NY Community Plan.


Below are the specialties that still require the referral. The members will need to contact their PCP office in order to obtain a referral and ensure that the Specialist will get reimbursed for the services provided.

  • Allergy and immunology
  • Dermatology
  • Endocrinology
  • Gastroenterology
  • General surgery
  • Neurological surgery
  • Orthopedic surgery
  • Otolaryngology
  • Physical medicine and rehabilitation/physiatry
  • Plastic surgery
  • Podiatry
  • Pulmonary medicine
  • Sports medicine
  • Urology
  • Vascular surgery

I am a provider, where should I go in order to request a referral?

Providers can request a referral on the UHC provider portal (UHCprovider.com ) Providers need to sign into the portal.


I am a provider and still have questions regarding the referral process, where should I go to find more infomation?

Provider can visit interactive guide in order to get more information regarding referral process.


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Recent Blog Posts:

#NYMedicaid, #UHCCommunityPlan #UHC #referrals #specialists

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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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