If you are a provider that accepts UHC Empire Plan in NY or a patient that has Empire plan then there are several important things that you should take notice of.
- Out of network allowed amounts: according to UHC- the reimbursement for OON providers is based on Medicare rates.
- Out of network acupuncture services: no matter how many providers that the member visits the maximum # of allowed visits is 20 per calendar year
- In network massage therapy services: only 20 visits are covered, per calendar year.
- Empire Plan mental health program that is administered by the Carelon Behavioral Health partnered with Hazelden Betty Ford Foundation to provide substance abuse services to the Empire plan members at no cost. Outpatient services are available in California, Florida, Illinois, Minnesota, New York, Oregon and Washington. Prior authorization is required.
If you find this type of information useful? Follow my blog for more up to date medical billing, coding, reimbursement and healthcare trends.
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