In non-emergent circumstances, you are required to refer our members to an in-network care provider. You can confirm if a care provider is in our network at UHCprovider.com, or call 877-842-3210.
For an exception to this requirement, you must either:
To get prior approval to involve an out-of-network care provider, submit a request by calling the number on the back of the member’s health care ID card. We review the request and network care providers available. If approved, we will apply the network benefits to the services done by the out-of-network care provider. We will mail our decision to the requesting care provider and the member.
To get a member’s written consent to involve an out-of-network care provider, you must use the Member Consent for Referring Out-of-Network form. The member must acknowledge that you:
For referrals to an out-of-network laboratory, use the Eligibility and Benefits (on Link) tool to provide us with the completed Member Consent for Referring Out-of-Network form.
If you violate this protocol, and do not confirm the member’s consent for the referral, you will be in violation of our Agreement. As a result, we may:
To find a list of care providers participating in the W500 network, go to UHCprovider.com/findprovider > Search for Care Providers in the General UnitedHealthcare Plan Directory > Medical Directory > All UnitedHealthcare Plans > Shopping Around > W500 Emergent Wrap