UHC to Implement Change to Radiology Notification Program in 2010

November 17, 2009

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The AAN has learned that UnitedHealthcare (UHC) is implementing a change to the Radiology Notification Program, effective February 15, 2010, whereby Premium Quality and Cost Efficiency (Q&E) Designated Physicians will be required to submit prior notification for advanced imaging services.

UHC asserts that the change is based on: (1) the concern for patients who are subject to preventable radiation exposure; and (2) direct feedback from practicing physicians and office managers who have also reported additional administrative complexity in managing these exemptions despite having an appreciation for the previous exemption of UnitedHealth Premium®-designated physicians. Consequently, UHC will simplify the program for all stakeholders by having the same administrative requirements for all physicians. This change does not affect physicians' current Premium Quality and Cost Efficiency (Q&E) designation status with UHC.

Hospitals, rendering physicians and facilities, and ordering Premium Q&E-designated physicians should have received a 90-day advanced notification starting November 16 including the following:

  • Frequently Asked Questions
  • Outpatient Radiology Notification Protocol
  • Quick Reference Guide

The Radiology Notification Program includes CT scans, MRIs, MRAs, PET scans, and nuclear medicine studies, including nuclear cardiology. A second reminder mailing will be distributed to the aforementioned physicians 30 days prior to the program change launch date of February 15, 2010.