UHC - New York State Chiropractic Association

UnitedHealthcare Announces Prior Authorization Reform Efforts

by Insurance Committee | May 13, 2026 | Commercial Insurance, Insurance Updates, Members Only, UHC

Last week, UnitedHealthcare announced it would be reducing prior authorization requirements for a variety of services by the end of this year. Unfortunately, there has been a fair amount of misinterpretation regarding UnitedHealthcare’s statement. On May 5, 2026,...

New York City Employee PPO Claims Processing Issue

by Insurance Committee | Mar 27, 2026 | Commercial Insurance, EmblemHealth, Insurance Updates, Members Only, UHC

The New York City Employee (NYCE) PPO plan is a new product and a new partnership between EmblemHealth and UnitedHealthcare. The product launched on January 1, 2026. The NYSCA Insurance Committee identified a claim processing issue and has been working to resolve the...

Several Payers Discontinue Medicare Advantage Benefits

by Insurance Committee | Jan 3, 2026 | Aetna, Cigna, Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, UHC

The NYSCA Insurance Committee (The NIC) monitors various aspects of rules, regulations and trends which impact our reimbursement. Over the past several years we have reviewed some of these during our meetings and presentations, and discussed possible changes that we...

UHC Medicare Advantage: Request for Redacted Denials

by Insurance Committee | Jul 2, 2025 | Insurance Updates, Medicare Advantage, Members Only, UHC

Have you received a UHC Medicare Advantage claim denial indicating ‘precertification/ authorization/ notification absent’ for cases where clinical submission was not required? Did you follow the correct process? If so, we...

UnitedHealthcare Modifies Manual Review Process for Medicare Advantage members

by Insurance Committee | Jan 13, 2025 | Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, UHC

If you participate with UnitedHealthcare / Optum you may have received notice of the change in the aforementioned prior authorization program. Based upon the volume of calls, texts and emails received by the NYSCA Insurance Committee (NIC), there has been several...

Medicare Advantage Prior Authorization Program Updates for UHC / AARP members

by Insurance Committee | Aug 26, 2024 | Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, UHC

The NYSCA continues to communicate with Optum regarding the implementation of the new prior authorization program for AARP and UnitedHealthcare’s Medicare Advantage members. We understand many of you have been attempting to determine the impact of this...