If you are a specialist in NY and are accepting UHC Community Health members? Then this blog post is for you!

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What is changing?

Staring DOS 1/1/26- if the member is going to see a specialist within the first 7 days of discharge from the Emergency Room or Hospital they will NOT require a referral!

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This applies tot he following specialties:

• 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

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Need additional visits?

• If the PT requires additional follow up visits (beyond 1 ) standard referral rules apply
• A referral request needs to be done through the PCP

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Find this information useful? Follow my blog for more!

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• UHC: NYS Community Health Plan- referrals update
• NYS Medicaid: Lactation services
• UHC: new genetic and molecular codes prior auth requirenment
• Emblem Health: billing for PT/OT services
• MVP: update home health prior auth