United Healthcare Radiology Guidelines

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Radiology Prior Authorization and Notification

(7 days ago) WebNotification and prior authorization may be required for these advanced outpatient imaging procedures: CT scans*. MRIs*. MRAs*. PET scans. Nuclear medicine studies, including nuclear cardiology. Authorization is not required for procedures performed in an …

https://www.uhcprovider.com/en/prior-auth-advance-notification/radiology-prior-authorization.html

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Outpatient radiology prior authorization protocol

(4 days ago) WebThe ordering health care professional’s office is responsible for notifying us before scheduling the advanced outpatient imaging procedure. However, in some situations the rendering health care professional is responsible for notifying us. See below for additional information about the rendering health care professional’s responsibilities.

https://www.uhcprovider.com/content/dam/provider/docs/public/prior-auth/radiology/COMM-Exchange-Radiology-Prior-Auth-FAQ.pdf

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Diagnostic Radiology Services – Medicare Advantage Policy …

(3 days ago) WebPurpose. The Medicare Advantage Policy Guideline documents are generally used to support UnitedHealthcare Medicare Advantage claims processing activities and facilitate providers’ submission of accurate claims for the specified services. The document can be used as a guide to help determine applicable:

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-guidelines/d/diagnostic-radiology-services.pdf

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Designated Diagnostic Provider UnitedHealthcare

(9 days ago) WebDesignated Diagnostic Provider benefits help protect members from higher, unjustified costs for outpatient lab or major imaging services while maintaining access to quality, safe, and efficient providers. These benefits are part of a strategy to lower overall healthcare costs. Member benefits for outpatient diagnostic lab and major imaging

https://www.uhc.com/member-resources/where-to-go-for-medical-care/care-options-and-costs/designated-diagnostic-provider

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New Prior Authorization Requirements and Updates from …

(7 days ago) WebNew Prior Authorization Requirements and Updates from United Healthcare for Radiology Claims with a date of service on or after November 1, 2020 containing the following PET CPT codes will be 78430, 78431, 78432 and 78433. This applies to United Healthcare (UHC) Commercial, UHC Community Plan and Medicare Advantage plans. Click here to …

https://apsmedbill.com/sites/default/files/whitepaper/uhc_prior_auth_requirements-updates_for_radiology.pdf

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American College of Radiology Releases New and Updated ACR

(9 days ago) WebReston, VA (April 26, 2021) — The American College of Radiology® (ACR®) today released an update to its ACR Appropriateness Criteria® (ACR AC), which includes 211 diagnostic imaging and interventional radiology topics with more than 1,000 clinical variants covering approximately 1,900 clinical scenarios.

https://www.acr.org/Media-Center/ACR-News-Releases/2021/American-College-of-Radiology-Releases-New-and-Updated-ACR-Appropriateness-Criteria

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UnitedHealthcare to implement outpatient advanced radiology …

(5 days ago) WebEffective January 1, 2019, UnitedHealthcare (UHC) will require prior authorization for certain advanced imaging procedures when performed in the outpatient hospital setting. As highlighted in the UnitedHealthcare Network Bulletin October 2018, certain magnetic resonance imaging, magnetic resonance angiography and computed tomography …

https://www.cmadocs.org/newsroom/news/view/ArticleId/27872/UnitedHealthcare-to-implement-outpatient-advanced-radiology-policy

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What’s preventive care and what’s covered? UnitedHealthcare

(5 days ago) WebWhat’s preventive care and what’s covered? What’s considered preventive care? Your annual physical care exam. Vaccines. Well-baby and well-child care. Recommended cancer tests and screenings at certain ages for skin, breast, colon, prostate, lung and cervical cancer. Other health screenings for things like osteoporosis and diabetes.

https://www.uhc.com/health-and-wellness/preventive-care

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Does Medicare cover cancer screenings, chemo & radiation?

(1 days ago) WebYes, Medicare will cover chemotherapy if you have cancer. Medicare Part A provides coverage if you’re a hospital inpatient, and Part B will provide coverage if you receive chemotherapy in a hospital outpatient setting, doctor’s office or freestanding clinic. If you receive chemotherapy as an outpatient, the location where you get treatment

https://www.uhc.com/news-articles/medicare-articles/medicare-coverage-for-cancer-screenings-chemo-and-radiation

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UnitedHealthcare eliminating prior authorization for more than 60

(8 days ago) WebThe nation’s largest commercial insurer is eliminating prior authorization requirements for more than 60 radiology services beginning next month. UnitedHealthcare announced on Aug. 1 that the total reductions across all specialties represent nearly 20% of overall procedural volumes. The Minnetonka, Minnesota-based insurer said it will begin

https://radiologybusiness.com/topics/healthcare-management/healthcare-economics/unitedhealthcare-eliminating-prior-authorization-radiology

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eviCore Cardiac Imaging Guidelines - V2.0.2023 - Effective …

(2 days ago) Webv2.0.2023. Hypertrophic Cardiomyopathy (HCM) is a clinical diagnosis, established by imaging with 2D echocardiography or cardiovascular magnetic resonance (CMR) showing a maximal end-diastolic wall thickness of ≥ 15 mm anywhere in the left ventricle, in the absence of another cause of hypertrophy in adults.

https://www.evicore.com/sites/default/files/clinical-guidelines/2023-06/eviCore-Cardiac-Imaging-Guidelines_V202023_eff07012023_pub03132023.pdf

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Facts About Imaging Procedures Radiation and Your Health CDC

(6 days ago) WebImaging procedures are usually performed in radiology or imaging centers in hospitals or clinics by a radiologist. Radiologists are medical professionals who are trained and certified to conduct imaging studies with radiation. Medical radiation practices and equipment are regulated by state and federal programs to ensure safety.

https://www.cdc.gov/radiation-health/data-research/facts-stats/imaging-procedures.html

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Find a doctor, dentist or provider UnitedHealthcare

(3 days ago) WebWith UnitedHealthcare health insurance plans, you'll have access to a large provider network that includes more than 1.3 million physicians and care professionals and 6500 hospitals and care facilities nationwide. 1 Sign in to your member account or search our guest directory to find a provider that's right for you. Member provider search.

https://www.uhc.com/find-a-doctor

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Radiologic Diagnostic Procedures

(1 days ago) WebRadiologic Diagnostic Procedures Page 2 of 6 UnitedHealthcare Medicare Advantage Coverage Summary Approved 12/13/2023 Proprietary Information of UnitedHealthcare.

https://www.012397.com/content/dam/provider/docs/public/policies/medadv-coverage-sum/radiologic-diagnostic-procedures.pdf

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Radiology and Imaging in New Jersey Hackensack Meridian Health

(4 days ago) WebOur radiology and imaging teams use state-of-the-art technology to accurately diagnose your medical condition and assist in developing the appropriate treatment plan. We offer a variety of services including: Bone Density, CT, Interventional Radiology, Mammography, MRI, Nuclear Medicine, PET-CT, Ultrasound and X-ray.

https://www.hackensackmeridianhealth.org/en/services/radiology-and-imaging

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Palisades Medical Center Imaging Services Hackensack Meridian …

(5 days ago) WebPalisades Medical Center Imaging Services offers flexible scheduling with day, evening, and weekend appointments for CT scans, MRI, XRAY, Ultrasound, Nuclear Medicine, PET-CT, Mammography, and Bone Density tests. Specialties include Chest CT angiogram, Contrast studies, MRA, Diagnostic and Vascular Ultrasound, and Musculoskeletal Imaging, …

https://www.hackensackmeridianhealth.org/en/locations/palisades-medical-center-imaging-services

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UnitedHealthcare Offers Prior Authorization Flexibility

(8 days ago) WebRadiology practices around the United States continue to feel the impact of the contrast media shortage used in many imaging exams due to COVID-19 shutdowns in Shanghai. GE Healthcare’s Omnipaque and Visipaque contrast media were added to the U.S. Food and Drug Administration’s drug shortage list on May 9.

https://www.acr.org/Advocacy-and-Economics/Advocacy-News/Advocacy-News-Issues/In-the-June-4-2022-Issue/UnitedHealthcare-Offers-Prior-Authorization-Flexibility

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Diagnostic Imaging - NJ Health Insurance & Healthcare Provider

(7 days ago) WebAll 78000 nuclear medicine studies are included in this section, please consult your Provider Manual to determine which nuclear studies require prior authorization or call eviCore healthcare for assistance 1-866-496-6200. Physicians to be certified by the American Board of Radiology (ABR) or the American Board of Nuclear Medicine (ABNM).

https://www.horizonblue.com/sites/default/files/2018-02/Diagnostic_Imaging_Privileging_Policy.pdf

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