A significant change is on the horizon. As of December 1, there will be a mandatory shift from paper-based to electronic submissions for medical pre-service appeals concerning commercial, UnitedHealthcare® Medicare Advantage, and Dual Special Needs Plan (D-SNP) plans. Providers will now be required to submit these appeals electronically. This change also brings the advantage of 24/7 access to pre-service appeal statuses via the UnitedHealthcare Provider Portal.
What Providers Need to Know:
• Effective December 1, medical pre-service appeal submissions for specified plans will be mandated to transition to an electronic format.
• This shift applies to commercial plans, UnitedHealthcare® Medicare Advantage, and Dual Special Needs Plan (D-SNP) plans.
• The new process will necessitate electronic submissions for pre-service appeals.
How to Submit a Medical Pre-Service Appeal:
• Utilize the Prior Authorization and Notification tool accessible through the UnitedHealthcare Provider Portal for the submission of medical pre-service appeals.
• Within the tool, providers will be guided through the process to locate the service reference number (SRN) and complete the appropriate online submission form.
The transition to mandatory electronic pre-service appeals marks a pivotal change in the submission process for the specified plans. Providers are encouraged to familiarize themselves with this new protocol to ensure a smooth transition and continued quality care provision for patients covered under these plans.
For further guidance or clarifications regarding this update, providers are advised to reach out to the appropriate channels to ensure a seamless transition and compliance with the new electronic submission process.
