tci ED Coding & Reimbursement Alert - 2021 Issue Q3

Reader Questions: UHC Delays New ED Policy

Question: When will UnitedHealthcare begin its new policy of denying ED facility visits that it classifies as “non-urgent?” Texas Subscriber Answer: The good news is that United is not currently going to implement the plan to halt pay for non-urgent ED visits, which had been scheduled for a July start date. The payer said that it will hold off on the plan to start the policy until after the pandemic ends. As part of its proposal, the company was essentially asking patients to make self-determinations of their diagnoses after evaluating their conditions. If, for example, a patient...

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