UnitedHealth launches ‘gold card' to ease prior authorization burden
UnitedHealth Group is launching a “gold card” program to help physicians override prior authorization requirements to more quickly deliver care to patients. The initiative begins Oct 1.
Under the terms of the program, approved physician practices will be exempt from submitting prior authorization requests for certain medical and mental health services. However, practices must still file a notice of advance eligibility before patients receive care for covered services, UnitedHealth said in its factsheet.
In order to earn “gold card status” a practice must have a prior authorization approval rate of 92% or higher for at least the last two years, having made at least 10 requests a year.
Patients covered under Medicare Advantage plans are eligible to receive care and accelerated approval under this plan, as are members with other forms of insurance, so long as they are using their plan in-network.
UnitedHealth said it will notify physicians through their portal if they meet the requirements. No application is required. Status will be redetermined on Oct 1 of every calendar year going forward.
“Practices may lose gold card status because of patient safety issues, failure to cooperate with quality and patient safety activities, not timely responding to requests for information, or if they no longer meet program requirements,” the fact sheet stated.
For now, the gold card program is available to providers in all 50 states. However, some states have passed regulations for gold card programs. UnitedHealth said it will modify the service to accommodate regional laws.
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