UHC placing ‘pre-pay’ review on some Covid claims
Multiple labs we work with have recently received pre-payment records requests from UnitedHealthcare to support their Covid-19 testing. While UHC isn’t denying these tests for improper coding, the payments they’ve put on hold amount to nearly $1 million in...
UHC now requiring G0416 for prostate biopsies across all products
FYI: This post originally ran in October 2020 when UHC first announced this move. We have bumped it to the top of our blog as a reminder the policy change is now in effect. After making the move to align prostate biopsies with G0416 for Medicare Advantage plans...
UHC issuing recoupments on 88305 prostate biopsies for Medicare Advantage members
We’ve recently seen many commercial payers move to only paying prostate biopsies coded G0416 instead of 88305 (for instance, Cigna will institute this rule effective Aug. 18). It’s not exactly a major surprise to see them adopting CMS guidelines on this...