United Healthcare (UHC): July 2023 Medical Policy Update
**Update: Effective Aug 1st, UHC reversed their decision to require a POC, but has kept their decision to require “time in / time out”. The rest of the article will state the original announcement.
UnitedHealthcare (UHC) has revised their Habilitation and Rehabilitation Therapy (Occupational, Physical and Speech) medical policy for their Commercial and Oxford Products. The revised effective date is July 1, 2023.
United Healthcare Commercial
The medical policy applies to ALL United Healthcare Commercial benefit plans.
United Healthcare Individual Exchange
The medical policy applies to Individual Exchange benefit plans in all states EXCEPT:
- Colorado,
- Massachusetts,
- Nevada, and
- New York.
Click below to access the full UHC Medical Policy Update:
https://www.uhcprovider.com/content/dam/provider/docs/public/policies/index/commercial/habilitative-services-outpatient-rehabilitation-therapy-07012023.pdf
The two elements that rehab providers need to especially pay attention to are:
- Including Start and Stop Times in the documentation
- Requirement for a Plan of Care (POC) Certification to be signed by the referring physician
Where can I make the necessary updates in OptimisPT?
Start and Stop Times: This can be found when you’re creating your document. If you do not see these fields, please let us know via the support tab and we’ll make sure the feature is toggled on for your practice:
POC Certification: To turn on the POC certification fields for UHC, it is done at the insurance level
You’ll then follow POC standards as you do with your Medicare patients. You’ll be able to filter the “Days to POC Expiration” and “Medicare Certification Status” reports for UHC patients to track them as well.
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