United HealthCare Modifies Prior Notification Program

May 17, 2010

United Healthcare has announced that it will be modifying its prior notification program in Florida, Missouri, North Carolina, Ohio, and Wisconsin based upon recent feedback from SCAI. The modified coverage policy is posted online.

Differentiating its prior notification program from prior approval programs, United HealthCare (UHC) says that all elective diagnostic cardiac catheterizations will be approved after a discussion between the treating physician and a cardiologist working for UHC. They also report that practices which rarely perform diagnostic catheterizations that UHC considers to be of questionable necessity will be "gold carded" and exempted from the prior notification program.

If you run into a problem with this program and/or have suggestions on how to improve it, please contact SCAI's Dawn Hopkins at dhopkins@scai.org (202-741-9854) or Wayne Powell at wpowell@scai.org (202-741-9869).