United Health Care letter – preauthorization confusion

A letter from United Health Care received yesterday indicated the need for preauthorization for behavioral health services.  I am researching this issue which is causing considerable confusion.  UBH does not know anything about this letter or its implications, but they are looking into it.  At present, the only preauthorization is 90837.  At present there is NO preauthorization for services for the entire plan.  Stay tuned for updates as they become available!  Please leave comments and ask any questions you may have!

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7 Responses to United Health Care letter – preauthorization confusion

  1. Lisa R. Cane, Ph.D. says:

    Hi Jerry,

    There has been the requirement of authorizations on a regular basis for The Empire Plan. They require on-going OTRs and send “cases” onto peer review when treatment is long term or requires increased frequency. I also have a patient with UHC with a self insured program. After x many sessions, they review it periodically in order to authorize continued treatment. So “pre-authorization” has been a part of some UHC and Optum contracts.
    Regards,
    Lisa Cane (lrc@optonline.net)

  2. Michael C. Singer, PhD says:

    I spoke with UBH last week about pre-authorization. Although they were not able to say which plans would need pre-authorization and which would not, none of my ongoing patients will be required to receive pre-authorization.

  3. Jason Greenberg, Ph.D. says:

    Thanks for the info, Jerry. As far as you know, is this true for in and out of network services?

  4. Lori Jeanne Peloquin, PhD says:

    The other question is if this applies to previous patients, or only new patients.

  5. John Prange says:

    United Health Care denied a calim with cpt 90837. have not had this problem with other Insurance companys a yet. I have always seen client a minmnium of 55 min. Usually up to 60 and billed 90806. With new cpt the code coresponding to 90806 is 90834 (45min). I know there are some therapists who see clients for 45 Min. but it doesen’t seem like enough time to me. ANyhow I will call UHC Alert Team line at 877-369-2198 and complain. Perhaps if enough people call they will make some changes.

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