06/15/2023

UnitedHealthcare shifts colonoscopy requirements from controversial ‘prior authorization’ to ‘advance notification’

UnitedHealthcare confirmed Thursday that starting this month, it will no longer require “prior authorizations” for commercial beneficiaries seeking non-screening colonoscopies and other gastroenterology endoscopy services. Rather, the insurer is requiring “advance notification” for such services.

The advance notification requirement involves providers collecting and submitting patient data to UnitedHealthcare online or by phone before performing a procedure. There are no changes to the insurer’s policy regarding colonoscopy procedures for routine screenings.

Providers who submit advance notifications will be eligible for UnitedHealthcare’s Gold Card program, which is expected to be implemented next year and, for care provider groups that meet eligibility requirements, will eliminate prior authorization requirements for most procedures, the company says.

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