Posted in #reimbursement, #unitedhealthcare, NY Providers, Training

NYS UHC Community Plan: which services require a referral?

With the uncertainty increasing in the Healthcare industry it is imperative to keep yourself updated on which plans require referrals from PCPs to see a specialty.


UHC Community Plan members might not require referrals for all of their specialists but some still do:

  • 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

Please make sure that the PCP goes on the https://www.uhcprovider.com/ and uses the referral solution in the Provider Portal to create a referral in order to avoid any unnecessary denials.


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Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC), AAPV Approved Instructor; and an owner of KR2 Medical Billing. I create educational material including blogs, presentations that focus on topics of medical billing, medical coding and reimbursement in healthcare.

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