Hello,
The SUD facility I work for is OON with this payer and was recently made aware that effective 07/01/2021 United Healthcare/Optum updated its coverage of OON benefits to exclude coverage of OON services provided outside of the member's "service area" Oddly the written announcement was only sent to their INN provider's and states the update applies to non emergent, sub-acute inpatient or outpatient services received at any of the following:
Has anyone received any further education regarding this change or any auth/claim(s) denials as a result of the update?
The SUD facility I work for is OON with this payer and was recently made aware that effective 07/01/2021 United Healthcare/Optum updated its coverage of OON benefits to exclude coverage of OON services provided outside of the member's "service area" Oddly the written announcement was only sent to their INN provider's and states the update applies to non emergent, sub-acute inpatient or outpatient services received at any of the following:
- Alternate Care Facility - PHP or IOP
- Freestanding Facility - Psych or SUD
- Residential Treatment Facility - Psych or SUD
- Inpatient Rehab Facility - Psych or SUD
Has anyone received any further education regarding this change or any auth/claim(s) denials as a result of the update?
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