United Healthcare is expanding its outpatient advanced imaging preauthorization requirements. Inpatient studies do not require preauthorization.
Beginning Feb. 15, all physicians participating with United’s commercial plans were required to obtain preauthorization for outpatient CT scans, MRIs, MRAs, PET scans, and nuclear medicine studies. Previously, physicians with the premium quality and cost efficiency designation were exempt from preauthorization requirements.
Starting June 7, 2010, United will expand outpatient preauthorization requirements to most Medicare Advantage products, including Secure Horizons and Evercare. The only exception will be those plans administered through Oxford.
United Healthcare said the change is intended to streamline administrative processes, reduce patient exposure to radiation, and ensure that advanced imaging procedures are given following evidence-based guidelines.