Starting Aug. 1, 2021, for UnitedHealthcare commercial benefit plans, including Oxford, Neighborhood Health Partnership and UnitedHealthcare of the River Valley, we’re changing our prior authorization requirements and site of service medical necessity reviews for certain surgical and office-based procedures.
Please note the following:
We’ll use the following Utilization Review Guidelines (URGs) and Oxford clinical policies to facilitate these site of service medical necessity reviews:
You can access these URGs after June 1, 2021 by visiting our Commercial Medical & Drug Policies and Coverage Determination Guidelines page and UnitedHealthcare Oxford Clinical, Administrative, and Reimbursement Policies.
More information is available in our Frequently Asked Questions:
Call Provider Services at 800-666-1353.