White Papers

New Prior Authorization Requirements from UHC for Labs in Ohio & Kansas

Starting on November 1, 2020 laboratories in Ohio and Kansas participating in United Healthcare’s (UHC) Community Plan and certain commercial plans will be subject to new prior authorization requirements for outpatient genetic and molecular testing. 

The notification/prior authorization requirements for certain genetic and molecular tests applies to:

•    Certain United Healthcare commercial benefit plans when UHC is the primary payer
•    Oxford Health Insurance
•    United Healthcare Community Plan in select states

Advance notification requests can be completed by either the lab performing the test or the ordering care provider. 

Click here to view United Healthcare’s Network Bulletin.  On Page 9 of the bulletin are several links that outline the current genetic and molecular tests that require prior authorization. To view Frequently Asked Questions, click here.

APS looks to provide ongoing support to our clients to help identify new carrier prior authorization requirement policies to help educate referring providers as well as their internal staffs.  

Recent White Papers

CARES Act Relief Funds Reporting Opens January 15, 2021
January 14th, 2021
Retro Payment Adjustments Announced by Medi-Cal
January 14th, 2021
Florida Medicaid Reverses Professional Component Payment Decision
January 14th, 2021
Federal Surprise Billing Legislation-The Rundown on the No Surprises Act
January 11th, 2021


The APS team constantly updates and educates us on any new changes in billing/coding that are happening or will be happening.

Mountain View, CA

Are you ready to start seeing increased revenues? APS’ expertise and commitment to service can get you there.
Begin your partnership with APS Medical Billing.
Contact Us