UnitedHealthcare Updates Referral Policy for New York Medicaid Members
UnitedHealthcare Community Plan in New York adjusted the process of getting referrals for Medicaid beneficiaries under its system. It works towards simplifying patient care access while minimizing administrative work for health providers.
Specialty services now require no referral from primary care providers for their main condition for care. Most UnitedHealthcare Community Plan New York Medicaid members can visit specialists directly instead of waiting for first approval from their primary care provider. The 15 specialty areas are the only ones that need a referral because other specialties are now accessible without approval.
These specialties include:
- Allergy and Immunology
- Dermatology
- Endocrinology
- Gastroenterology
- General Surgery
- Neurological Surgery
- Orthopedic Surgery
- Otolaryngology (ear, nose, and throat)
- Physical Medicine and Rehabilitation (also known as Physiatry)
- Plastic Surgery
- Podiatry
- Pulmonary Medicine
- Sports Medicine
- Urology
- Vascular Surgery
Inside the UnitedHealthcare Provider Portal, healthcare providers can transmit their referral submissions to achieve authorization. Providers accessing the UHC provider website should navigate to the Sign In function located within the top right section. The website provides an interactive guide that demonstrates how members can follow the different steps.
UnitedHealthcare adopts this update as part of its healthcare optimization initiative that benefits patients and medical care providers. Members receive quicker care accessibility when providers reduce their practice in unwarranted referrals, while minimizing administrative workloads.
Get in touch with UnitedHealthcare Community Plan if you have any queries about the referral procedure or require further information.
