Effective July 1, 2020, certain UnitedHealthcare commercial members will no longer have benefits for out-of-network Laboratory, Dialysis and Durable Medical Equipment (DME) services.
UnitedHealthcare requires physicians and other qualified health care professionals to inform our members when involving an out-of-network providers in the member’s care for non-emergent services.
If you do not obtain the member’s consent for an out-of-network referral for non-emergent services, you will be in violation of your agreement. As a result, we may, depending on state law:
- Disqualify you from any rewards or incentive program
- Decrease your fee schedule
- Hold you financially responsible for any costs collected from a member by a non-participating care provider
- Terminate your Agreement
- Disqualify the provider from any rewards or incentive program
Resources
Consent Form: Member Consent for Referring Out-of-Network Form
Provider Protocol Requirements: UHCprovider.com > Chapter 5: Referrals > Non-Participating Care Providers (All Commercial Plans)
How do I find a network provider?
You can visit myuhc.com or UHCprovider.com to search for providers near you. You can also call us at the toll-free member phone number on the member’s health plan ID card.
- UHCprovider.com > Find Dr. > Clinics or Facilities by Plan Type
- MyUHC.com – Find a Doctor > Find a Provider
- By Phone: Call the toll-free phone number on the member’s ID card