logo
Live CEUs Completed
Live CEUs Tracker: 0 Completed Updating...
UHC to Remove Prior Authorization for Some Radiology and Cardiology Tests

Coding

UHC to Remove Prior Authorization for Some Radiology and Cardiology Tests

Starting January 1, 2026, certain nuclear imaging tests, OB/GYN ultrasounds, and cardiology tests will no longer require prior authorization.

 

These changes fall under the  following plan types:

 

  • UnitedHealthcare Insurance Company
  • UnitedHealthcare Mid-Atlantic, Inc. 
  • UnitedHealthcare Plan of the River Valley, Inc. and UnitedHealthcare Insurance Company of the River Valley 
  • Oxford Health Insurance, Inc.
  • United Healthcare Level Funded (formerly All Savers Life Insurance Company of California)
  • Neighborhood Health Partnership, Inc.
  • UnitedHealthcare Individual Exchange plans, also referred to as UnitedHealthcare Individual and Family ACA Marketplace plans
  • UnitedHealthcare Services, Inc.
  • UnitedHealthcare Community Plans

 

Some of the affected codes:

(Source: UHC.com) 

 

For a full list of affected codes, visit: https://www.uhcprovider.com/en/resource-library/news/2025/removal-prior-auth-radiology-cardiology.html

 

Source: Kateryna Patskovska, CPB, AAPC Approved Instructor (CPB-I), has over 17 years of experience in the healthcare field, serving in various positions, including medical receptionist, medical biller, supervisor, and practice manager.

 

https://kr2billing.com/

 
Spotlight on November 2025 FWA

Spotlight on November 2025 FWA:A diagnostic laboratory headquartered in Indianapolis, Indiana, agreed to pay the United States $9,620,000 to resolve allegations that it violated the False Claims Act and the Anti-Kickback Statute (AKS).
Patient Financial Responsibility: Turning Collection Challenges Into Opportunities

Billing

Patient Financial Responsibility: Turning Collection Challenges Into Opportunities :As high-deductible health plans become increasingly common, more financial responsibility is being shifted from insurers to patients.
The Denial Dilemma: Why Healthcare Claims Are Failing and How to Fix Them

Practice Management

The Denial Dilemma: Why Healthcare Claims Are Failing and How to Fix Them :Claim denials have grown to be more than a nuisance, as they pose a material threat to provider revenue, operational efficiency and compliance risk. For healthcare facilities, clinics and specialty providers alike, an increasing share of submitted claims are being denied, appealed or indefinitely delayed.
What Is the Real Impact of the 2026 MPFS Proposed Rule on Radiology Practices?

Coding

What Is the Real Impact of the 2026 MPFS Proposed Rule on Radiology Practices?:While the initial impression of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2026 was an increase of 3.83% or 3.32% depending upon a physician's APM status, the real story is told by doing further analysis.
The Twelve Days of HIPAA

Security

The Twelve Days of HIPAA:The Holidays and the New Year are a great time to assess HIPAA compliance, emerging threats and upcoming obligations in 2026. It is with the “Spirit of the Season” that I have compiled twelve (12) items for covered entities and business associates alike to consider.
How Proper Use of Taxonomy Codes Prevents Denials and Ensures Compliance

Coding

How Proper Use of Taxonomy Codes Prevents Denials and Ensures Compliance:In the complex world of healthcare administration, accuracy and compliance are paramount.
ICD-10 Vitamin D Deficiency (E55.9): A Complete Guide

Coding

ICD-10 Vitamin D Deficiency (E55.9): A Complete Guide:Did you know that almost one billion people around the world are affected by vitamin D deficiency?
2026 ICD-10-CM Changes

Coding

2026 ICD-10-CM Changes:Effective October 1, 2025, the 2026 ICD-10-CM update is live, with 480+ new codes, 38 revisions, and 28 deletions.
Bridging the Gap: Real-World Tools Revolutionizing Healthcare Management Education

Practice Management

Bridging the Gap: Real-World Tools Revolutionizing Healthcare Management Education:It's graduation day for Sarah, a bright-eyed healthcare management major who's spent four years buried in textbooks and case studies.
Navigating Political Differences in Healthcare: Building Productive Teams in a Divided World

Practice Management

Navigating Political Differences in Healthcare: Building Productive Teams in a Divided World:In today's politically charged climate, especially amid rapid shifts in U.S. healthcare policies, medical practice managers face unique challenges.
Strategies for Predictive Denial Management: Leveraging Data Analytics to Minimize Revenue Loss

Practice Management

Strategies for Predictive Denial Management: Leveraging Data Analytics to Minimize Revenue Loss:Claim denials continue to be one of the most persistent challenges in healthcare revenue cycle management (RCM). Now, what if you could predict which claims are likely to be denied-before they even reach the payer?
Spotlight on October 2025 FWA

Auditing

Spotlight on October 2025 FWA:A 76-year-old man was arraigned on four counts of felony Medicaid Fraud.

 

 

 

 

 

 

 

 

 

Get More - BC Magazine

Subscribe now to access more resources than ever before!

Current Issue - OUT NOW

January / February| Issue 20.1

 

Magazine | CEUs | Webinars