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UnitedHealthcare delays outpatient advanced radiology policy until February 1

Citing the need for additional time for communication and optimal rollout, UnitedHealthcare (UHC) has delayed implementation of its outpatient advanced radiology policy until February 1, 2019.  The new UHC policy—originally scheduled for implementation on Jan. 1—requires prior authorization for advanced imaging procedures, including certain magnetic resonance imaging, magnetic resonance angiography and computed tomography imaging procedures, when performed in the outpatient hospital setting.  Under UHC’s Outpatient Radiology Notification/Prior Authorization Protocol, a site of care review will be required for these advanced imaging services when performed in the outpatient hospital. Site of care ...

Anthem Blue Cross to implement restrictive outpatient advanced radiology policy

Effective December 1, 2017, Anthem Blue Cross will implement a new policy restricting outpatient advanced radiologic imaging procedures in the hospital setting. The updated policy, originally scheduled to become effective October 1 but recently delayed, indicates that advanced radiologic imaging procedures in the hospital outpatient department are only considered medically necessary under the follow circumstances: If services are only available in the hospital setting; or  The patient requires obstetrical observation; or  The patient is receiving perinatology services; or  ...